The Importance of Levator Function in Determining the Levator Resection Surgery Results for Blepharoptosis Patients

Abstract

Objective: To compare the results of external levator resection in the upper eyelid blepharoptosis patients who have moderate and good levator function (LF). Material and Methods: This is a prospective study of 57 patients who had undergone levator resection from January 2015 to May 2016. LF was graded before surgery as moderate (5-10 mm) and good (10-15 mm) on the basis of the eyelid excursion. Preoperative and postoperative detailed information including age, gender, etiology, side, marginal reflex distance 1 (MRD1) change, operating time, cosmetic outcome and reoperations were recorded. Postoperative measurements at the 6th month visit was used for comparison. Results: The patient group consisted of 24 females (42.1%), 33 males (57.9%) with a mean age of 46.33 (range:7-79) years. Of the surgical procedures 77.1% (44/57) had good LF, 22.9% (13/57) had moderate LF. The age of the patients who had good LF was statistically significantly lower than the patients who had moderate LF (p=0.020). The operation time for the patients with good LF was statistically significantly lower than the patients who had moderate LF (p=0.001). MRD1 change and reoperation rate between two groups were not statistically significant (p>0.05). For the good LF patients, the final cosmetic outcome was statistically significantly good (p=0,012). Conclusion: For the blepharoptosis patients with good LF, the operation time is shorter and the final cosmetic outcome is better than the moderate LF blepharoptosis patients. As a conclusion, this study figured out the relevance of the preoperative assessment of LF in planning the surgical strategy for the treatment of blepharoptosis.