Changes in Eyelid Height Based on Intra-Operative Quantification of Levator Aponeurosis Advancement in Patients with Unilateral Ptosis.

Objective: To present marginal reflex distance (MRD-1) outcomes based on intra-operative quantification of levator aponeurosis advancement.

Methods: Forty-eight patients with unilateral aponeurotic ptosis underwent anterior levator aponeurosis advancement. Distance of advancement intra-operatively was compared with MRD-1 outcomes at the immediate postoperative sitting, approximately 1 week, and 1 month period. Surgical success was defined as a symmetric MRD-1 or an MRD-1 within 1 millimeter of the contralateral eyelid.

Results: Most MRD-1 exhibited the following trends: 1) initial decrease at about 1 week and increase at 1 month ( = 11), 2) initial increase at about 1 week with levelling at 1 month ( = 8), and 3) increasing through time ( = 7). Success rate significantly decreased through time ( = .0464). The change in proportion of successful and failed surgeries was insignificant. Surgical revision rate was 10.4%.

Conclusion: Levator aponeurosis advancement distances do not correlate with MRD-1 outcomes linearly. MRD-1 exhibited stability over time with a satisfactory success rate at 1 month.