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Surgical Techniques

Surgical procedures include: Correction of acquired ptosis might be performed in a number of different ways.

  • Ptosis can be caused by the apneurosis of the levator muscle, nerve abnormalities, trauma, inflammation or lesions of the lid or orbit.
  • Dysfunctions of the levators might occur as a lead to of a lack of nerve communication being sent to the receptors due to antibodies needlessly attacking and eliminating the neurotransmitter.
  • Ptosis might be due to a myogenic, neurogenic, aponeurotic, mechanical or traumatic cause and it usually occurs isolated, but might be associated with various other conditions, like immunological, degenerative, or hereditary disorders, tumors, or infections.
  • Acquired ptosis is most commonly caused by aponeurotic ptosis. This can occur as a lead to of senescence, dehiscence or disinsertion of the levator aponeurosis. Moreover, chronic inflammation or intraocular surgery can lead to the same effect. Also, wearing contact lenses for long periods of time is thought to have a certain impact on the development of this condition.
  • Congenital neurogenic ptosis is believed to be caused by the Horner syndrome.
  • In this case, a mild ptosis might be associated with psilateral ptosis, iris and areola hypopigmentation and anhidrosis due to the paresis of the Mueller muscle. Acquired Horner syndrome might lead to after trauma, neoplastic insult, or even vascular disease.
  • Ptosis due to trauma can ensue after an eyelid laceration with transection of the upper eyelid elevators or disruption of the neural input.
  • Other causes of ptosis include eyelid neoplasms, neurofibromas or the cicatrization after inflammation or surgery. Mild ptosis might occur with aging.

Levator resection (Anterior/External approach)

  • Skin incision
  • Adjustment is based on eyelid position during surgery patient is awake
  • May be combined with cosmetic upper blepharoplasty

Müller muscle resection  (Poster / Internal approach)

  • Ideal for patients with minimal excess skin
  • No visible skin incision
  • May be combined with cosmetic upper blepharoplasty
  • Candidates for this procedure respond to 2.5% phenylephine place behind the upper eyelid. See slider animation below.

Frontalis sling operation

  • The idea of the frontalis sling procedure is to transfer the elevating function of the ptotic eyelid to the frontalis muscle.
  • Required when the degree of ptosis is severe
  • To achieve this, the eyelid is directly suspended to the brow using various materials.Creates a ‘sling’ from the frontalis muscle (brow) to the eyelid.
    • synthetic materials, such as ptoseup, Supramid suture, Gortex, silicone, or Mersilene mesh might also be used.
    • Fascia (autogenous or donor using material such as BioElevation™ Ptosis Slings
  • performed for congenital ptosis
  • Because the sling material has little elasticity, a tethering effect on downgaze, Lagophthalmosxare expected postoperatively
  • Allows patient to be asleep since surgical repair is based on formula

Surgical Details with Animated Surgical steps of Ptosis Surgery

Treatment Details Surgery Videos of Ptosis Surgery

Non-surgical modalities like the use of "crutch" glasses or special Scleral contact lenses to support the eyelid might also be used.





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