الفهرس 
Surgical anatomy of the levator muscleOnly 14 pages are availabe for public view
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Abstract
Congenital ptosis is usually a result of a localized dystrophy of the levator muscle in which the striated muscle fibers are replaced with fibrous and fatty tissue. The condition may be unilateral or bilateral and can be familial, transmitted as an autosomal dominant (AD) trait. Although ptosis in children is often an isolated finding, it may occur in association with other ocular or systemic disorders (87, 59).
A complete ophthalmic and systemic examination is therefore important in the evaluation of a child with ptosis. Amblyopia may occur in children with ptosis. The amblyopia may be deprivational or induced astigmatism (anisometropia). When amblyopia occurs, it should generally be treated before correcting the ptosis. Treatment of ptosis in a child is indicated for elimination of an abnormal head posture, improvement in the visual field, prevention of amblyopia, and restoration of a normal eyelid appearance (49).
The timing of surgery depends on the degree of ptosis, its cosmetic and functional severity, the presence or absence of compensatory posturing and the wishes of the parents. Surgical treatment is determined by the amount of levator function that is present and degree of ptosis (50, 88).
The aim of the present work is to evaluate recent lagophthalmos formula method for predicting postoperative eyelid level as regard the success rate, cosmetic results and complications. Excluding all cases with acquired, traumatic and congenital ptosis associated with other ocular or systemic disorders. Accurate history was obtained from all patients and full ophthalmological assessment was done.
The study included 20 eyelids of 17 cases that were diagnosed as having simple congenital blepharoptosis with levator function more than 4 mm and collected from Menoufia University Hospital. All patients followed for 6 months postoperatively. Assessment of MRD-1 at each follow up visit at second day, 1st week, 3rd month and 6th month.. Any complication was noticed and treated accordingly.
Mean age of the study patients was 8 years. Criteria was chosen to evaluate success rates including MRD1 within 3-4.5mm and eyelid height difference ≤1mm. The results showed that the successful outcomes of the technique regarding MRD 1 within 3-4.5 mm at the end of follow up (6 months) was met by 15 (75%) eyelids of 20 eyelids. All complication reported in this method mainly attributed to any ptosis surgery.