Levator Plication versus Resection in Congenital Ptosis - A Prospective Comparative Study

Purpose: To compare levator plication with resection in congenital ptosis. Methods: Prospective comparative randomized trial involving 20 eyes of 20 patients with age > 4 yrs, simple mild-to-moderate congenital ptosis with good-to-fair amount of levator action were included. Patients were randomized to either levator resection or plication. Outcome was compared in terms of eyelid height and course of postoperative events. Data was compared using the paired and unpaired t-test. Results: The mean M.R.D. 1 at the end of 3 months in Group A was 2.8 +/- 1.23 mm and in Group B was 1.12 +/- 0.83 mm (p value = 0.001). Plication did not improve levator action much. Resection lead to more alterations in Bell's, lid lag, lagophthalmos and persisting edema (3 cases). Conclusion: In 70% cases of congenital ptosis, good cosmetic outcome can be achieved with levator resection. With levator plication there are greater chances of drooping from fourth week onwards. The technique of plication, though simpler in approach failed to correct dystrophic muscle in congenital ptosis.