A 26-year-old woman requests correction of 1.5 mm of bilateral ptosis. Levator function is 15 mm bilaterally, the lid crease is present, and there is no jaw-winking. The MOST appropriate surgical procedure is:
- A Conjunctivomullerectomy (Muller muscle-conjunctival resection) ✓
- B Frontalis suspension with silicone rod
- C Maximal levator resection
- D Whitnall sling procedure
Correct answer: A. Conjunctivomullerectomy (Muller muscle-conjunctival resection)
Explanation
Mild ptosis (roughly 2 mm or less) with excellent levator function is ideally corrected by Muller muscle-conjunctival resection, which lifts the lid via Muller muscle and gives predictable results when the phenylephrine test is positive. Levator resection is reserved for moderate to severe ptosis or poorer function, and frontalis suspension is for poor levator function below 4 mm. There is no established Whitnall sling procedure in routine practice.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
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Written and medically reviewed by the StethoPrep medical team.