Outcomes of Posterior Approach Surgery in Various Types and Grades of Upper Eyelid Blepharoptosis in Indian Eyes.

Purpose: To present the outcomes of levator plication (levatorpexy) surgery by posterior approach for correction of ptosis of different aetiologies in Indian eyes.

Methods: Retrospective review of clinical notes and clinical photos of consecutive ptosis patients who underwent levatorpexy from January 2017 to September 2018. Surgery was considered successful if the following four criteria were simultaneously met: a postoperative MRD1 of ≥2 mm and ≤4.5 mm, inter eyelid height asymmetry of ≤1 mm, no overcorrection compared to the opposite eye, and a satisfactory eyelid contour determined by patient.

Results: Thirty six eyelids of 36 patients (mean age, 23.6 years; 25 females) underwent unilateral levatorpexy with the left eyelid affected in 66.6 %. Twenty one congenital (58.3%) (C), 12 (33.3%) aponeurotic (A) and 3 (8.3%) complex ptosis (CX) had a mean levator function of 9.8 mm (range, 6 to 15). Mean pre and post operative margin reflex distance (MRD 1) was 0.611mm (range, -1 to 3 mm) and 3 .00 mm (range, 2 to 4 mm) respectively. At the final follow up of 12 months, four patients remained under corrected (11.1%). At the final follow up of twelve months, the success rate was 78 percent.

Conclusion: Posterior approach for ptosis repair offers a scar less, minimally invasive, easy to revise, and successful lid height correction in congenital and acquired ptosis.