Total transplantation of the superior rectus muscle for ptosis. A new surgical approach.

In cases of ptosis 45 per cent are severe in degree with poor levator function, 25 per cent are bilateral, and 60 per cent have good superior rectus function. Ptosis with the jaw-winking phenomenon accounts for 6 per cent of cases of congenital ptosis (Berke, 1949), and in these the levator palpebrae is either poorly functioning or has to be sacrificed. Total transplantation of the superior rectus muscle into the eye lid has been specifically designed for cases of severe ptosis with poor levator function. Embryological, anatomical, and physiological similarities make the superior rectus the most natural substitute for a defunct levator muscle. In the last 2 1/2 years, we have operated upon fifteen severely ptotic lids (four bilateral and seven unilateral) by transplantation of the superior rectus muscle. The results were satisfactory in thirteen cases, with slight undercorrection in two.