“…Ptosis surgery generally falls into three categories: frontalis suspension techniques, external/transcutaneous repair of the levator complex, or internal/transconjunctival repair of the Müller's muscle, tarsus, conjunctiva, or levator complex. Accurate assessment of the etiology of ptosis is essential and can direct the surgeon to the most appropriate surgical options; however, there is significant variation in preoperative evaluation [3][4][5] . In particular, the use of phenylephrine testing to identify suitable candidates for internal repair and to estimate postoperative outcomes has recently been revisited [6,7] .…”
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 Müller's muscleconjunctiva 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.
“…Ptosis surgery generally falls into three categories: frontalis suspension techniques, external/transcutaneous repair of the levator complex, or internal/transconjunctival repair of the Müller's muscle, tarsus, conjunctiva, or levator complex. Accurate assessment of the etiology of ptosis is essential and can direct the surgeon to the most appropriate surgical options; however, there is significant variation in preoperative evaluation [3][4][5] . In particular, the use of phenylephrine testing to identify suitable candidates for internal repair and to estimate postoperative outcomes has recently been revisited [6,7] .…”
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 Müller's muscleconjunctiva 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.
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