A prospective study of aponeurotic ptosis and its management at tertiary eye hospital

• Author Details:   
• Kalaiselvi Balasubrahanian
• Sangamithira Mathiyalagan

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Introduction: Ptosis is an upper eyelid problem which is seen in children and adults. Ptosis can reduce the visual fields and affect the quality of life. In adults, ptosis are due to an abnormality in the levator aponeurosis. Levator aponeurosis advancement surgery is done for aponeurotic ptosis.
Aim: To study the incidence, clinical feature and surgical outcome of aponeurotic ptosis in this study population.
Materials and Methods: This hospital based prospective one year study included all patients with a clinical diagnosis of aponeurotic ptosis(26 case with 33 ptosis) who were subjected to complete examination of ptosis. Levator advancement surgery through the transcutaneous approach was performed in 30 aponeurotic ptosis and followed up for 6 months.
Results: Aponeurotic ptosis (23.85%) is common among the acquired ptosis. Majority of aponeurotic patients were male (61.54%) and between the age group of 20-45 yrs. 30 ptosis were corrected surgically by levator aponeurotic advancement surgery (transcutaneous approach). 87% of cases had good success rate at 6 month follow up.
Conclusion: Aponeurotic levator advancement through transcutaneous approach gives good results functionally and cosmetically. In this procedure excess skin can be excised and creating future lid crease is easier. Levator advancement can be combined with blepharoplasty. This procedure can be performed not only by the plastic surgeon but also by the general ophthalmologist.

Keywords: Aponeurotic ptosis, Blepharoplasty, Incidence, Levator advancement, Transcutaneous approach