Use of the orbicularis oculi muscle flap for severe Marcus Gunn ptosis.

The authors present a 22-year-old man with severe unilateral congenital blepharoptosis associated with Marcus Gunn (jaw-winking) syndrome. The best conventional treatment was levator excision to eliminate the synkinetic reflex and fascia lata brow suspension. However, the previous surgery had some disadvantages. Therefore, the authors report the use of the orbicularis oculi muscle flap to elevate dynamically the ptotic eyelid and to eliminate the synkinetic reflex without levator resection. The postoperative result was both functionally and cosmetically satisfactory after 1 year of follow-up.