Long-term Outcomes of Combined Levator and Müller Muscle Resection for Congenital Ptosis
Author: Aaron Zhao
Base Hospital / Institution: Perelman School of Medicine at the University of Philadelphia
Abstract ID: 25-380
Purpose
To evaluate the efficacy and durability of combined levator and Müller muscle resection for correction of congenital ptosis by assessing long-term changes in margin reflex distance (MRD) and rates of reoperation.
Methods
A retrospective chart review identified 41 patients (16 right eye, 25 left eye) who underwent combined levator and Müller muscle resection for congenital ptosis between 2009-2025 and had documented follow-up at the Children’s Hospital of Philadelphia. All procedures were performed by a single surgeon. Preoperative and postoperative MRD measurements were compared using paired t-tests. Secondary outcomes included reoperation rates, average follow-up time, and long-term stability of eyelid height.
Results
The cohort included 21 male and 20 female patients with a mean ± SD age of 6.0 ± 5.0 years (range 0.3-15.9). Mean preoperative MRD was 0.65 ± 0.95 mm, improving to 3.26 ± 1.27 mm postoperatively, representing an average improvement of 2.61 ± 1.25 mm (p<0.001). Only 5 patients (12.2%) required additional ptosis surgery during the follow-up period, which averaged 13.5 ± 25.0 months. Long-term eyelid position was stable, with 72.2% of patients showing less than 1 mm of change between immediate postoperative and final MRD measurements (mean absolute change 1.25 ± 0.99 mm, average rate of change 0.19 ± 0.32 mm/month). The racial distribution included White (68.3%), Black or African American (17.1%), and Other (14.6%) patients.
Conclusion
This study demonstrates that combined levator and Müller muscle resection is an effective surgical approach for congenital ptosis correction with significant improvement in eyelid elevation. The technique provides durable results with a low reoperation rate over a mean follow-up exceeding one year. These findings support the inclusion of this combined approach in the surgical management algorithm for congenital ptosis.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Yasaman | Ataei | Children’s Hospital of Philadelphia |
| William | Katowitz | Children’s Hospital of Philadelphia |
