Adjustable Sutures for the Correction of Adult-Acquired Ptosis

The current state of ptosis repair

“…A number of authors reported the use of adjustable sutures that decreased the reoperation rate to 5-18% [28][29][30]. Another modification is a posterior approach levator advancement with sparing of the conjunctiva and Mü ller's muscle, which has been described with success rates similar to those of the external levator advancement and MMCR.…”

Outcome and Influencing Factors of External Levator Palpebrae Superioris Aponeurosis Advancement for Blepharoptosis

“…2 In addition, there have been multiple published descriptions of variations in surgical technique with similar good results. 4,[7][8][9][10] Due to relatively small samples sizes, conclusions regarding clinical characteristics, which identify patients at increased risk of unfavorable surgical results, have been limited in most series. Berlin and Vestal found that patients with minimal blepharoptosis, MRD between 2 and 4 mm, had favorable outcomes more often than patients with more severe blepharoptosis; however, no effect of the magnitude of levator function was observed.…”

What Is the Best Way to Handle the Involutional Blepharoptosis Repair?

“…There are 3 main approaches to correct IB: the first is targeted on the external levator superioris aponeurosis, the second on Müller muscle, and the third involving both. [1][2][3][4][5][6][7][8][9][10][11][12] If the procedure is targeted on the Müller muscle, the lidocaine with epinephrine, which stimulates sympathetic nerves in the Müller muscle, is constricted with epinephrine so that the eyelid height decreases. 9,22,23 When the effect of the local anesthetic, however, fades away postoperatively, the upper eyelid droops and eyelid height are expected to increase.…”

“…1 IB repair to obtain adequate visual field by levator aponeurosis advancement is successful in most instances; however, the postoperative eyelid height is not uniformly predictable. [2][3][4][5][6][7] The main factor in this unpredictable correction seems to be dependent upon insufficient intraoperative evaluation. If we can accurately predict postoperative eyelid height using measurement obtained during surgery, we could achieve an increase in the rate of steady outcomes.…”