COMPARATIVE ANALYSIS OF THE EFFICACY AND SAFETY OF DIFFERENT BLEPHAROPLASTY TECHNIQUES FOR THE TREATMENT OF EYELID PTOSIS IN ADULTS

Abstract

Eyelid ptosis in adults is a significant functional and aesthetic condition, and surgical treatment aims to restore eyelid height and symmetry. Surgical approaches vary depending on the etiology and severity of the ptosis. This study aimed to compare the efficacy and safety of the main blepharoplasty techniques for the correction of eyelid ptosis in adults. A systematic literature review was conducted, following the PRISMA guidelines, with searches of the PubMed, SciELO, and Web of Science databases for comparative studies published in the last 10 years. The descriptors used were "eyelid ptosis," "blepharoplasty," "levator aponeurosis advancement," "Müller muscle resection," and "frontal suspension." The results indicated that posterior Müller muscle resection with conjunctiva (MMCR) is highly predictable and effective for mild to moderate ptosis with a positive phenylephrine test, offering faster recovery and reduced morbidity. In contrast, anterior levator aponeurosis advancement demonstrated greater versatility, allowing intraoperative adjustment and concomitant treatment of dermatochalasis, and is applicable to a wider range of ptosis. Forehead suspension remained the technique of choice for cases with severely compromised levator muscle function. It is concluded that surgical technique selection should be individualized, based on levator function, the degree of ptosis, and the response to pharmacological tests. This careful approach allows for sustained functional and aesthetic results, with a high safety profile and a low incidence of significant complications.