Long-term Prognosis of Levator Aponeurosis Plication for Aponeurotic Ptosis Caused by Conjunctivitis: A Case Report

Abstract Purpose: To report a rare clinical case of a patient suffered from unilateral aponeurotic ptosis caused by conjunctivitis and evaluate the long-term prognosis of levator aponeurosis plication technique. Methods: Levator aponeurosis plicationtechnique with local anesthesia was preformed to treat the patient and made a moderate overcorrection of the patient's ill eye. Follow up for 4 months to record patient’s recovery. Results: During the operation, we saw there were little orbital septal fat left and lots of strip fibrous adhesions between orbital septum and the levator aponeurosis. Postoperative follow-up showed a good recovery with approximately the same degree of opening in both eyes and no complications such as incomplete closure. Conclusion: Conjunctivitis will cause massive inflammatory cellular infiltration and fibrin exudation which may even spread to the surface of the levator aponeurosis. When there is no barrier of orbital septal fat, the fibrin will fibrate into tenacious adhesions, form scar-like tissue that causes the dysfunction of the levator aponeurosis, eventually results in ptosis. The release of the adhesions followed by levator aponeurosisplication procedure can completely improve the ptosis symptoms.