Abstract
Background. Levator transposition is used as a unilateral procedure for patients with both ptosis and aberrant movements of the eyelid. Muscular neurotisation occurs in the transposed levator muscle and thus some levator function is restored.
Method. We reviewed 35 patients who had undergone a levator transposition procedure.
Results. Twenty-eight patients had jaw-winking ptosis, three had cyclic oculomotor palsy and four had a third nerve palsy with aberrant regeneration. The follow-up period was between 1 and 39 months (mean 12 months). Eighteen patients were followed up for at least 12 months and their results were analysed as a separate group.
Conclusions. The levator function attained following transposition is related to the pre-operative voluntary function and this relationship is statistically significant (Wilcoxon test p<0.001). Maximal levator function may not be achieved until 12 months post-operatively. The procedure is successful in abolishing aberrant eyelid movements and treating ptosis but the majority of patients require an additional levator resection to achieve a satisfactory lid height.
Similar content being viewed by others
Article PDF
References
Crawford JS . Repair of ptosis using frontalis muscle and fascia lata. Trans Am Acad Ophthalmol Otolar-yngol 1956;60:672–8.
Beard CA . New treatment for severe unilateral ptosis and for ptosis with jaw winking. Am J Ophthalmol 1965;59:252–8.
Dryden RM, Fleming JC, Quickert MH . Levator transposition and frontalis sling procedure in severe unilateral ptosis and the paradoxically innervated levator. Arch Ophthalmol 1982;100:462–4.
Neuhaus RW . Eyelid suspension with a transposed levator palpebrae superioris muscle. Am J Ophthalmol 1985;100:308–ll.
Lemagne J-M, Brucher JM, Michiels J . Clinical, biochemical and histological results of a levator muscle transposition for ptosis in Cynomolgusmonkeys. Orbit 1985;4:141–6.
Lemagne J-M . Transposition of the levator muscle and its reinnervation. Eye 1988;2:189–92.
Collin JRO . A manual of systematic eyelid surgery. 2nd ed. London: Churchill Livingstone, 1989;49–61.
Collin JRO . New concepts in the management of ptosis. Eye 1988;2:185–8.
Knapp P . Tr Am Ophthalmol Soc 1969;67:304–21.
Betharia SM, Kumar S . Levator sling for Marcus Gunn ptosis. Br J Ophthalmol 1987;71:685–9.
Lemagne J-M . Frontalis transposition of levator palpebrae superioris in a patient with Marcus Gunn ptosis. Bull Soc Belge Ophtalmol 1986;219:13–9.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Manners, R., Rosser, P. & Collin, J. Levator transposition procedure: A review of 35 cases. Eye 10, 539–544 (1996). https://doi.org/10.1038/eye.1996.124
Issue Date:
DOI: https://doi.org/10.1038/eye.1996.124
Keywords
This article is cited by
-
Paediatric blepharoptosis: a 10-year review
Eye (2009)