Journal List > J Korean Ophthalmol Soc > v.55(12) > 1009851

Kim and Ahn: Surgical Outcomes of Levator Resection in Ptosis Patients with Deep Superior Sulcus



To investigate the characteristics and postoperative complications of ptosis patients with deep superior sulcus following levator resection surgery.


Records of 33 ptosis patients (59 lids) with deep superior sulcus who underwent levator resection surgery from March 2008 to May 2013 were reviewed retrospectively. Operation success rate, reoperation rate, preoperative and postoperative marginal reflex distance 1 (MRD1), and levator function were compared and postoperative complications were evaluated.


The patient's mean age was 65.8 years. The MRD1 was −1.0 ± 1.4 mm preoperatively, 2.5 ± 1.2 mm at 1 month after surgery, and 2.3 ± 1.1 mm at 3 months after surgery. Operation success rate was 84.8%. At 1 month after surgery, 52.5% of lids had lagophthalmos as a surgery complication but later all recovered. Additionally, 44.1% of the patients had worn therapeutic contact lenses postoperatively for 7.0 ± 12.1 days.


Occurrence rate of postoperative lagophthalmos was higher than in other previous studies suggesting a tendency for overcorrection in levator resection surgery for ptosis patients with deep superior sulcus. Additionally, levator resection surgery is cosmetically as well as functionally very effective for deep superior sulcus. J Korean Ophthalmol Soc 2014;55(12):1734-1738


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Figure 1.
(A, C, E) Preoperative findings for the deep superior sulcus patients. (B) Postoperative photographs showing that the deep superior sulcus improved. (D) Postoperative photographs showing that the deep superior sulcus partially improved. (F) Postoperative photographs showing that the deep superior sulcus was not improved.
Table 1.
Demographic characteristics of patients
Characteristic Description
Number of patients (no. of eyes) 33 (59)
Sex (M:F) 5:28
Age (years) (range) 65.8 ± 7.1 (48-81)
Preop. LF (mm) 8.24 ± 2.6
Preop. MRD1 (mm) −1.0 ± 1.4

Values are presented as mean ± SD unless otherwise indicated. LF = levator function; MRD1 = marginal reflex distance 1.

Table 2.
Postoperative deep superior sulcus improvement
Deep superior sulcus Rate (%, persons)
Total (n = 33) Improved 30.3 (10/33)
Partially improved 45.5 (15/33)
Not improved 24.2 (8/33)
Success group (n = 28) Improved 35.7 (10/28)
Partially improved 42.9 (12/28)
Not improved 21.4 (6/28)
Fail group (n = 5) Improved 0.0 (0/5)
Partially improved 60.0 (3/5)
Not improved 40.0 (2/5)
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