Standardized suture placement for mini-invasive ptosis surgery.

Objective: To report a refinement of small-incision external levator advancement with a standardized method for suture placement for correction of acquired blepharoptosis and 1 surgeon's results with this technique.

Methods: Retrospective medical record review of data from all patients with unilateral or bilateral acquired blepharoptosis who underwent small-incision external levator advancement from October 1, 2007, through January 31, 2011.

Results: Ninety-two eyelids from 66 patients with acquired blepharoptosis were treated with small-incision external levator advancement with uniform suture placement. Forty patients underwent unilateral surgery and 26 underwent bilateral surgery. The mean preoperative margin-to-reflex distance was 0.70 mm. The mean postoperative margin-to-reflex distance was 2.95 mm. Symmetry was achieved in 49 patients (74%) on the basis of a less than 1-mm difference in margin-to-reflex distance. When stratified by unilateral ptosis repair vs bilateral ptosis repair, bilateral ptosis repair achieved greater symmetry on average (81% vs 70%). Nine patients underwent revision. There were only 2 postoperative complications: one was postoperative upper eyelid bleeding and the other was exposure keratopathy.

Conclusion: The simplified method of suture placement for small-incision external levator advancement is an effective, safe, and efficient option for acquired ptosis correction.