Enhanced Fasanella–Servat Procedure for the Graded Repair of Blepharoptosis

    loading  Checking for direct PDF access through Ovid



To describe in detail a technique for a modified Fasanella–Servat procedure that provides a simplified method for graded Mueller muscle excision with minimal and controlled tarsal excision.


A retrospective study of 71 patients (102 eyelids) who underwent the modified Fasanella–Servat procedure is reported. Measurements include the preoperative, post-phenylephrine, and postoperative margin-to-reflex distance-1, and postoperative upper eyelid height symmetry as determined by the absolute difference between right- and left-sided margin-to-reflex distance-1. Postoperative complications are reported.


The average increase in margin-to-reflex distance-1 was 2.4 mm with an average postoperative upper eyelid height symmetry of 0.4 mm. Postoperative asymmetry was 1.5 mm or less in 68 patients, a success rate of 96%. Four patients (6%) exhibited overcorrection, 2 of which required additional surgery. No lagophthalmos or notable eyelid contour abnormalities were seen.


The modified Fasanella–Servat technique offers a simple method to isolate and resect Mueller muscle and a minimal segment of tarsus in a quantitative fashion, allowing for a graded repair of blepharoptosis and thereby decreasing the risk of postoperative overcorrection, lagophthalmos, and eyelid contour asymmetry whilst preserving the bulk of tarsus.

Related Topics

    loading  Loading Related Articles