Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis

Objective: To compare the efficacy and efficiency of anew small anterior incision, minimal dissection ptosis procedure with that of a traditional anterior aponeurotic approach for the correction of aponeurotic ptosis. Design: Retrospective, comparative, interventional case series. Participants: Seventy-two patients with aponeurotic ptosis who had undergone ptosis correction surgery by 1 surgeon: 36 patients (49 ptotic eyelids) who had ptosis correction by a small-incision, minimal dissection procedure and 36 patients (49 ptotic eyelids) who had ptosis correction by a traditional aponeurotic approach. Methods: Charts and available photographs were reviewed for each patient. Main Outcome Measures: Postoperative upper eyelid height relative to the center of the pupil and relative to the opposite upper eyelid and the postoperative eyelid contour. Results: Successful correction of the eyelid height and the rate of recommended reoperation were not significantly different for the 49 lids corrected in each arm of the study. The incidence of attaining good eyelid contour was significantly better in the small incision group, in which 41 of 42 lids (97.6%) evaluated by photographs had good contour compared with 29 of 37 lids (78.4%) in the traditional group. Operating time per lid was significantly less for the small-incision, minimal dissection group, 25.3+/-13.0 minutes (range, 13-68 minutes) compared with 55.4+/-16.6 minutes (range, 35-119) for the traditional group. Conclusions: The small-incision, minimal dissection technique for ptosis correction is equally effective in correcting eyelid height, superior in producing desirable eyelid contour, and much quicker to perform than the traditional aponeurotic approach. Ophthalmology 2004;111:2158-2163 (C) 2004 by the American Academy of Ophthalmology.