Blepharoptosis Repair: External Versus Posterior Approach Surgery: Why I Select One over the Other

Liza M Cohen; Daniel B Rootman

doi:10.1016/j.fsc.2021.01.002

Blepharoptosis Repair: External Versus Posterior Approach Surgery: Why I Select One over the Other

Facial Plast Surg Clin North Am. 2021 May;29(2):195-208. doi: 10.1016/j.fsc.2021.01.002. Epub 2021 Feb 16.

Authors

Liza M Cohen¹, Daniel B Rootman²

Affiliations

¹ Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California Los Angeles, Los Angeles, 300 Stein Plaza, Los Angeles, CA 90095, USA.
² Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California Los Angeles, Los Angeles, 300 Stein Plaza, Los Angeles, CA 90095, USA. Electronic address: rootman@jsei.ucla.edu.

PMID: 33906756
DOI: 10.1016/j.fsc.2021.01.002

Abstract

Ptosis surgery is performed via an anterior/external or posterior/internal approach, primarily defined by the eyelid elevator muscle surgically addressed: the levator complex anteriorly or Muller muscle posteriorly. Posterior ptosis surgery via Muller muscle conjunctival resection is an excellent first choice for cases of mild to moderate ptosis with good levator function, as it is predictable, provides a reliable cosmetic outcome, requires no patient cooperation during surgery, portends a lower rate of reoperation, and rarely leads to lagophthalmos and/or eyelid retraction postoperatively. External levator resection is preferred in patients with severe ocular surface/cicatricial conjunctival disease, shortened fornices, and lesser levator function.

Keywords: Blepharoptosis; External levator resection; Eyelid; Muller’s muscle conjunctival resection; Ptosis surgery.

Publication types

Review

MeSH terms

Blepharoplasty*
Blepharoptosis* / surgery
Eyelids / surgery
Humans
Oculomotor Muscles / surgery
Retrospective Studies