Ptosis repair: external levator advancement vs. Muüller’s muscle-conjunctiva resection - techniques and modifications

Abstract

Surgical techniques for ptosis repair continue to evolve as we gain a better understanding of the anatomy and physiology of the eyelid. External repair by levator advancement and internal repair by Muüller’s muscle-conjunctiva resection are the most established surgical techniques used for acquired ptosis today. Controversy over their relative indications, advantages, and disadvantages exist. The advent of new surgical techniques and modifications has further complicated traditional algorithms that guide a surgeon towards choosing an external vs. internal approach. Specifically, the use and interpretation of pre-operative phenylephrine testing has recently been challenged. The purpose of this study is to review the evolution of external and internal ptosis repair techniques, and current trends in pre-operative evaluation and surgical management of acquired ptosis.

Keywords

Blepharoptosis / ptosis / levator advancement / Muüller’s muscle-conjunctiva resection

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