Abstract ID: 26-181
Clinical Outcomes of Anterior Levator Plication for Blepharoptosis
Author: Ananth Ranjit Base Hospital / Institution: Northern Care Alliance NHS Foundation Trust
Presentation Type: ePoster Presentation
Purpose
To evaluate clinical outcomes of anterior levator plication for blepharoptosis in a large retrospective cohort
Methods
Retrospective case series of patients undergoing anterior levator plication (2016–2025). Primary outcome was change in margin reflex distance 1 (MRD1). Surgical success was defined as a post-operative MRD1 greater than 2 mm and less than 4.5 mm. Secondary outcomes included lid contour, complications, and revision rates. The surgical technique involved conservative skin excision where indicated, identification of the levator aponeurosis via an anterior approach and plication to the tarsal plate using 6-0 Vicryl and 6-0 nylon sutures.
Results
A total of 185 eyes were included. The cohort comprised 62 male (33.5%) and 123 female (66.5%) patients; mean age 68.6 ± 18.2 years; predominantly White British (88.6%). Aponeurotic ptosis accounted for 97% of cases. Mean MRD1 improved significantly from 1.28 ± 0.88 mm pre-operatively to 3.58 ± 0.89 mm post-operatively (p<0.001). Overall success was achieved in 73.5% of eyes. Success rates were higher in moderate (71.4%) and severe (77.1%) ptosis compared to mild (45.5%). Complications were infrequent (infection 1%, keratitis 0.5%). Revision surgery was required in 13% of cases. Lid contour was satisfactory in the majority.
Conclusion
Anterior levator plication achieved significant and clinically meaningful improvement in eyelid height with a low complication profile. The revision rate compares favourably with published outcomes. The technique appears particularly effective for aponeurotic ptosis, where controlled plication allows reliable correction of eyelid height and contour. The predominance of aponeurotic ptosis limits generalisability to congenital, myogenic, and neurogenic cases, where alternative techniques may be more appropriate. In dystrophic levator muscle, resection may be preferable to plication for optimal eyelid position. Anterior levator plication is a safe and effective tissue-preserving option for predominantly aponeurotic ptosis, providing significant improvement in MRD1 with acceptable revision rates.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Jacob | Morning | Northern Care Alliance NHS Foundation Trust |
| Farhan | Qureshi | Northern Care Alliance NHS Foundation Trust |