External Levator Advancement and Resection

Abstract

Blepharoptosis occurs from congenitally or acquired mechanical, neurogenic, myogenic, or traumatic etiologies leading to drooping of the upper eyelid. Ptosis in elderly patients most commonly presents as dehiscence of the levator aponeurosis insertion and thinning of the aponeurotic fibers [1]. The aponeurotic repair of ptosis, originally described by Everbrush in 1883, grew in popularity in 1975 after Jones reported a new technique resecting a portion of the flaccid aponeurotic tissue [2]. The technique continued to be modified over time as the role of the disinsertion of the levator aponeurosis in involutional ptosis was more clearly understood [3].