Evaluation of transconjunctival levator tucking for congenital ptosis

Purpose The purpose of this paper is to evaluate the efficacy, cosmetic results, and safety of transconjunctival tucking of the levator aponeurosis for correction of simple congenital ptosis. Patients and methods This was a prospective interventional noncomparative case-series study. This study was carried out at the Ophthalmology Department of Minia University Hospital. Thirty eyelids of 24 patients with simple congenital ptosis with fair to good levator muscle function (≥5 mm lid elevation) were subjected to transconjunctival tucking of levator aponeurosis. All patients were subjected to an assessment of history and a full ophthalmological examination. The degree of ptosis was evaluated using marginal reflex distance 1. Levator muscle function was evaluated while fixing the eyebrow. Preoperative and postoperative digital photographs were used for documentation. Results Anatomical success was achieved in 26 (86.7%) eyelids. Undercorrection was present in four (13.3%) eyelids. No case of overcorrection was encountered. Undercorrection was associated with more severe ptosis and less levator muscle function. Good cosmetic outcomes were obtained in the majority of cases. Apart from undercorrection, no significant postoperative complications occurred during the study. Conclusion Levator aponeurosis tucking using the posterior transconjunctival approach is safe and effective for correcting simple congenital blepharoptosis, with good cosmetic outcomes. This technique is especially useful for mild and moderate cases of congenital ptosis associated with fair to good levator muscle function