ArticleJPRAS open2026
Refinement of maximal levator resection for blepharoptosis correction: High incision and advancement of levator complex.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
Background: Maximal levator resection (MLR) is indicated for severe blepharoptosis with poor levator function (LF) but carries risks of intraoperative bleeding due to dissection above the tarsus, conjunctival perforation, and postoperative conjunctival prolapse. To address these issues, we introduce the High Incision and Advancement of Levator Complex (HIAL) technique, designed to optimizing functional and aesthetics outcomes while minimizing complications. Objectives: This study evaluates the effectiveness of HIAL technique in reducing surgical complications in severe congenital blepharoptosis. Methods: Nine pediatric patients with congenital severe blepharoptosis underwent HIAL procedure. The levator complex was dissected 8-10 mm above the superior tarsal border and extended toward Whitnall's ligament to create a 10 × 5 mm rectangular flap, which was then advanced and secured to the tarsus. Results: The mean levator resection measured 24.67 ± 0.87 mm. Postoperative outcomes demonstrated significant improvements in palpebral fissure height (PFH), marginal reflex distance 1 (MRD1), and LF (all Conclusions: The HIAL technique may represent a feasible and potentially effective option for managing severe blepharoptosis with poor LF, providing both functional and aesthetic benefits while reducing surgical complications.
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