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Sub-tarsal Ptosis Surgery
1Kutschan A., 2Wiegand W.,
1Klinikum Nord-Heidberg, Augenabteilung (Hamburg)
2Klinikum Nord Heidberg, Augenklinik (Hamburg)
Background: Surgery of acquired ptosis remains a real challenge in lid surgery procedures. Despite various operation techniques the results are still not reliably predictable.
Methods: After the eversion of the upper lid the conjunctiva is dissected subtarsally up to the fornix. The levator complex is then suspended with three strings. At the upper rim of the tarsus the complex of Müllers muscle and levator aponeurosis are dissected and separated up to the fornix. The levator complex is then fixed at the upper rim of the tarsus with three further suspension strings. The levator muscle complex is resected and the remaining muscle stump is reattached at the upper rim of tarsus. The conjunctiva is now repositioned and adapted with a contineous suture and the strings are removed.
Results: The described technique is applicable for all patients without previous lid surgery and leads to a satisfactory lid elevation function. It can easily be learned and has a relatively low complication rate. A resection range of 5-9 mm leads to a lid elevation of 1-4 mm.
Conclusion: By our subtarsal ptosis surgery procedure good functional and cosmetical results can be achieved.