An Anterior Approach for Resection and Advancement of the Levator.

RESECTION and advancement of the levator palpebrae superioris gives the best functional and cosmetic result of any ptosis operation. As a rule, operation on the levator is indicated if there is a degree of function in this muscle. Myasthenia gravis, the myopathies, jaw-winking, and related anomalies of innervation are the exceptions to this rule. Bowman was perhaps the first to attempt correction of ptosis by resection of the levator, either by the conjunctival or by the skin approach (Bader, 1857). Nothing can be achieved by the posterior approach that cannot be achieved by the anterior approach. The latter is particularly indicated when the levator action is poor. It is the purpose of this paper to describe a simple technique for resection and advancement of the levator by way of an anterior approach.