[Skip to Content]
[Skip to Content Landing]
September 1993

Whitnall's Sling With Superior Tarsectomy for the Correction of Severe Unilateral Blepharoptosis

Author Affiliations

From the Departments of Ophthalmology and Otolaryngology, St Louis (Mo) University School of Medicine (Dr Holds); the Department of Ophthalmology, the Mayo Clinic at Jacksonville (Fla) (Dr McLeish); and the Division of Oculoplastic, Orbital and Oncologic Surgery, Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City (Dr Anderson).

Arch Ophthalmol. 1993;111(9):1285-1291. doi:10.1001/archopht.1993.01090090137032

The management of severe unilateral blepharoptosis is problematic. In the presence of poor levator function, conventional surgical techniques frequently do not adequately elevate a ptotic eyelid. From May 1988 through July 1991, we used 4- to 5-mm external resections of the superior tarsus in conjunction with a maximal aponeurectomy (Whitnall's sling procedure) to augment blepharoptosis correction in selected cases of severe unilateral blepharoptosis. Seventeen (68%) of 25 patients with poor levator function blepharoptosis who underwent this new surgical procedure achieved a lid height within 1 mm of the opposite lid with good or excellent ocular function, cosmesis, and eyelid crease formation. Mild to moderate degrees of exposure keratopathy developed early in the postoperative period in all patients. This exposure keratopathy ultimately resolved in most patients. Superior tarsectomy safely augments the blepharoptosis correction of a Whitnall sling procedure in severe blepharoptosis, improving the results of aponeurotic surgery in patients with severe unilateral blepharoptosis.