Transcutaneous Blepharoptosis Surgery: Simultaneous Advancement of the Levator Aponeurosis and Müller’s Muscle (Levator Resection)

Kazunami Noma1, Yasuhiro Takahashi2, Igal Leibovitch3, Hirohiko Kakizaki*, 2
1 Noma Eye Clinic, Kokutaiji, Naka-ku, Hiroshima 730-0042, Japan
2 Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
3 Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel

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open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan; Tel: +81-561-62-3311; Fax: +81-561-63-7255; E-mail:


Transcutaneous blepharoptosis surgery with simultaneous advancement of the levator aponeurosis and Müller’s muscle (levator resection) is a popular surgery which is considered effective for all types of blepharoptosis except for the myogenic type. Repair of ptosis cases with good levator function yields excellent results. A good outcome can be also obtained in cases with poor levator function, however, in such cases; a large degree of levator advancement may be required, which may result in postoperative dry eyes, unnatural eyelid curvature and astigmatism. These cases are therefore better treated with sling surgery. With the right patient selection, the levator resection technique is an effective method for ptosis repair.

Keywords: Transcutaneous blepharoptosis surgery, levator aponeurosis, Müller’s muscle, levator resection.