Modified split-level lid resection for blepharoptosis.

Mustardé's split-level lid resection surgery was popular through the 1980s for the correction of blepharoptosis with 7 mm or more of levator function. Although the aesthetic results gained with this technique were good, last line deformity and eyelid margin irregularities, such as central peaking at forward and upward gaze, were experienced. A simple modification of the tarsal resection pattern of Mustardés operation has solved these complications. In the treatment of 24 ptotic eyelids (12 unilateral, 6 bilateral with a modified split-level lid resection procedure), symmetrical appearance and level eyelids were obtained without lid margin peaking at 5 years' follow-up. The only persistent complication was lid lag at down-gaze in 10 eyelids.