TACTICS OF SURGICAL TREATMENT OF UPPER EYELID PTOSIS OF VARIOUS ETIOLOGIES

Abstract

Upper eyelid ptosis is a clinically and aesthetically significant condition that may occur due to congenital, acquired, neurogenic, myogenic, traumatic, inflammatory, involutional, or postoperative causes. The choice of surgical correction requires careful preoperative assessment because insufficient evaluation of eyelid biomechanics, levator function, tarsal plate resistance, ocular surface status, and associated systemic diseases may lead to recurrent ptosis, lagophthalmos, and unsatisfactory aesthetic outcomes. This article presents the tactics of surgical treatment of upper eyelid ptosis of various etiologies, with emphasis on the role of vector forces involved in eyelid movement. The study included 55 patients with ptosis of different etiologies who underwent surgical treatment between 2025 and 2026. The main group was treated using an original method based on relaxation of the tarsal plate before eyelid correction, while the comparison group underwent conventional surgical techniques. The results showed that consideration of biomechanical vector forces and reduction of tarsal plate resistance improved functional and aesthetic outcomes, decreased the probability of recurrence, and eliminated the risk of pathological lagophthalmos. The proposed approach may therefore be considered an effective surgical tactic for individualized correction of upper eyelid ptosis.