Multilevel full-thickness eyelid resection for the correction of severe acquired ptosis in the poorly functioning eyelid.

Six eyelids (4 patients) with severe myogenic (4 eyelids), neurogenic (1 eyelid), or mechanical (1 eyelid) ptosis underwent surgical correction with a multilevel full-thickness resection of eyelid tissue combined with a plication of the levator aponeurosis-Müller's muscle complex. All eyelids had poor levator function, fair to poor orbicularis function, and a poor Bell's phenomenon. In all cases, the upper eyelids were elevated to an acceptable functional level without exposure keratopathy. This resection procedure preserves orbicularis function while allowing correction of severely ptotic eyelids with poor levator function, providing an acceptable alternative to other techniques for correcting this problem.