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Background <p>Pediatric myogenic ptosis has a high incidence, and severe cases significantly impair children’s visual function and quality of life. Long-term untreated, it can lead to amblyopia and adverse psychological impacts. Traditional surgical interventions have drawbacks, including high complication rates, relapse, patient discomfort, and unsatisfactory long-term stability, resulting in unmet clinical needs. The Levator Aponeurosis-Preserving Levator Muscle Shortening Procedure (LAPLMSP) is an innovative approach, and this study is the first to explore its application in pediatric patients, aiming to address the challenges of treating this delicate condition in a vulnerable population.</p> Methods <p>This retrospective cohort study analyzed 102 pediatric patients (mean age 3.88 years) with severe ptosis. All had a marginal reflex distance 1 (MRD1) &lt; 1 mm and impaired levator function. LAPLMSP was performed under general anesthesia, focusing on preserving the levator aponeurosis while shortening the levator muscle. Postoperative outcomes were monitored at 1 week, 1 month, 6 months, 10 months, and 1 year.</p> Results <p>LAPLMSP significantly improved MRD1 from a preoperative mean of 0.40 mm to 5.19 mm at 1 week, 4.54 mm at 1 month , 3.87 mm at 6 months, 2.94 mm at 10 months, and 2.84 mm at 12months (p &lt; 0.001). All caregivers reported high satisfaction with their children’s improved functional and aesthetic outcomes. Minor complications, such as over-correction and under-correction, resolved spontaneously without additional interventions.</p> Conclusions <p>LAPLMSP is a viable and effective treatment for severe pediatric myogenic ptosis, providing substantial functional and aesthetic improvements with high caregiver satisfaction. Its minimally invasive nature, low complication rate, and favorable stability make it a superior option for managing this challenging condition in children.</p> Level of Evidence II <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Preservation of Levator Aponeurosis in Levator Muscle Shortening for Pediatric Myogenic Ptosis: A Retrospective Cohort Study with 1 Year Follow-up

  • 期刊论文

  • 发表日期：

    2026年3月19日

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  • Hai-Lin Hu,
  • Jun-Fang Wang,
  • Xiao-Ping Bi,
  • Wo-Dong Shi

摘要

Background

Pediatric myogenic ptosis has a high incidence, and severe cases significantly impair children’s visual function and quality of life. Long-term untreated, it can lead to amblyopia and adverse psychological impacts. Traditional surgical interventions have drawbacks, including high complication rates, relapse, patient discomfort, and unsatisfactory long-term stability, resulting in unmet clinical needs. The Levator Aponeurosis-Preserving Levator Muscle Shortening Procedure (LAPLMSP) is an innovative approach, and this study is the first to explore its application in pediatric patients, aiming to address the challenges of treating this delicate condition in a vulnerable population.

Methods

This retrospective cohort study analyzed 102 pediatric patients (mean age 3.88 years) with severe ptosis. All had a marginal reflex distance 1 (MRD1) < 1 mm and impaired levator function. LAPLMSP was performed under general anesthesia, focusing on preserving the levator aponeurosis while shortening the levator muscle. Postoperative outcomes were monitored at 1 week, 1 month, 6 months, 10 months, and 1 year.

Results

LAPLMSP significantly improved MRD1 from a preoperative mean of 0.40 mm to 5.19 mm at 1 week, 4.54 mm at 1 month , 3.87 mm at 6 months, 2.94 mm at 10 months, and 2.84 mm at 12months (p < 0.001). All caregivers reported high satisfaction with their children’s improved functional and aesthetic outcomes. Minor complications, such as over-correction and under-correction, resolved spontaneously without additional interventions.

Conclusions

LAPLMSP is a viable and effective treatment for severe pediatric myogenic ptosis, providing substantial functional and aesthetic improvements with high caregiver satisfaction. Its minimally invasive nature, low complication rate, and favorable stability make it a superior option for managing this challenging condition in children.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.