For levator palpebrae muscles hyperactive and spastically contracting from thyroid disorder or for a levator shortened too much in surgical correction of ptosis, they or it are recessed the estimated distance and the end of the levator tendon is connected to the tarsus either by an intermediary sector of pretarsal orbicularis or with a strip of collagen film (Ethicon). Before describing this technique, it may be of interest to briefly review the procedures previously devised for levator recession.
The classic procedure for recession is Goldstein's method (1934) which may be performed via either the skin or conjunctiva. After separating the levator from the conjunctiva behind and the orbicularis in front, and allowing it to recede into the upper fornix and orbit for 10 mm, the lower end of the levator tendon is attached to the skin and orbicularis muscle beneath the eyebrow with three mattress sutures tied over rubber strips.
CALLAHAN A. Levator RecessionWith Reattachment to the Tarsus With Collagen Film. Arch Ophthalmol. 1965;73(6):800-802. doi:10.1001/archopht.1965.00970030802009