The aponeurotic approach for the correction of blepharoptosis.

Blepharoptosis results from underaction of the eyelid protractors relative to the eyelid retractors causing the eyelid to be lower than its normal anatomic position. The lowering of the upper eyelid obstructs the superior visual field. Patients suffering from ptosis complain of eyelid asymmetry, fatigue, and difficulty reading. Ptosis is classified into categories based on the underlying anatomic abnormality. The categories: myogenic, aponeurotic, neurogenic, and mechanical may be differentiated based upon the levator function and the clinical examination. The type of ptosis and the degree of levator function determine which surgical interventions may be considered in an individual patient. The aponeurotic approach to the correction of blepharoptosis provides versatility and may be used for all degrees of ptosis provided the levator function is adequate. The aponeurotic approach allows for concomitant correction of associated dermatochalasis and eyelid crease abnormalities. Eyelid height and contour may be adjusted intraoperatively to obtain the most consistently favorable post-operative results. Early postoperative adjustment enables revision of the eyelid with minimal additional surgical trauma.