The modified fasanella-servat procedure: description and quantified analysis

Ophthalmic Plast Reconstr Surg. 2013 Jan-Feb;29(1):30-4. doi: 10.1097/IOP.0b013e318272d304.


Purpose: To describe a modified Fasanella-Servat procedure and nomogram for the correction of minimal amounts of ptosis.

Methods: Retrospective review of this modified Fasanella-Servat procedure was performed on 118 eyelids in 86 consecutive patients over 2, 4-year periods by 1 surgeon (S.C.D.). The amount of tarsectomy was based on the amount of ptosis.

Results: Mean pre- and postoperative margin-to-reflex distance 1 were +0.7 mm and +2.4mm, respectively. One hundred and twelve eyelids (95%) had satisfactory results with postoperative margin-to-reflex distance 1 ≥ 1.5 mm. Eyelid symmetry was achieved in 92% of eyelids to within 0.5 mm. There was no incidence of overcorrection, tarsal buckling, or corneal abrasion. One eyelid had a contour deficit. Tarsectomy amount ranged from 2 mm to 5 mm. Average amount of tarsectomy to eyelid elevation was 2.4:1.

Conclusions: The modified Fasanella-Servat procedure is technically easy, time-efficient, and has a low complication rate for the treatment of minimal blepharoptosis (< 2.5 mm) with good levator function and negative phenylephrine test. In the authors' hands, the ratio of tarsectomy to eyelid elevation is approximately 2:1. In addition to other techniques such as levator advancement and Müller's muscle conjunctival resection, the modified Fasanella-Servat technique is a useful adjunct to the modern ptosis surgeon's armamentarium.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blepharoptosis / surgery*
  • Blinking
  • Child
  • Child, Preschool
  • Eyelids / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Nomograms
  • Ophthalmologic Surgical Procedures / instrumentation
  • Ophthalmologic Surgical Procedures / methods*
  • Postoperative Complications
  • Retrospective Studies
  • Suture Techniques
  • Treatment Outcome
  • Young Adult