A patient presents with a 3 mm ptosis, absent lid crease, and poor levator function (< 4 mm). The MOST appropriate surgical procedure is:

• A Fasanella-Servat procedure (tarsoconjunctival resection)
• B Frontalis sling with autogenous fascia lata ✓
• C Levator resection (Everbusch/Beard technique)
• D Müller's muscle-conjunctival resection (MMCR)

Explanation

With poor levator function (< 4 mm), the levator muscle cannot be relied upon and a frontalis sling is the procedure of choice; the frontalis muscle is used to lift the lid. Fasanella-Servat is suitable for mild ptosis (< 2 mm) with good levator function. Levator resection is used for moderate ptosis with fair/good levator function (> 4 mm). MMCR is a posterior approach used for mild ptosis with good levator function and a positive phenylephrine test.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.