That levator resection gives the most natural and physiologically normal result in ptosis surgery is common knowledge; the complications which may ensue are perhaps not so well known. Some of these complications are due to errors of commission and omission and are preventable. Others will occur in the most skilled and experienced hands despite all precautions.
It was Bowman1 who opened this Pandora's box of postoperative trials and tribulations for us in 1857, when 6 cases of levator resection done by him both by skin and conjunctival routes were reported. Since then this operation with many modifications has been repeatedly rediscovered and has acquired many eponyms. But if it is anyone's, it is Bowman's procedure by right of precedence and original publication.
The indication for levator resection is clear. There should be some levator function. I have abandoned levator resection where there is no levator action. I have experienced
FOX SA. Postoperative Complications of Levator Surgery. Arch Ophthalmol. 1961;65(3):345-352. doi:10.1001/archopht.1961.01840020347006