{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T02:11:30Z","timestamp":1770948690220,"version":"3.50.1"},"reference-count":12,"publisher":"Korean Ophthalmological Society","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekjo.org"],"crossmark-restriction":true},"short-container-title":["Korean J Ophthalmol"],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:p>Purpose: To describe our experience with transconjunctival white line advancement surgery in aponeurotic ptosis patients with fair to good levator function.Methods: A retrospective analysis was conducted on 23 eyes with mild to severe involutional ptosis that underwent white line advancement surgery over a 1-year period. All patients demonstrated fair to good levator function. Preoperative data collected included demographics, marginal reflex distance 1 (MRD1), vertical palpebral aperture height (VPA), lid crease distance, levator function, Bell\u2019s phenomenon, extraocular movements, and icepack test. The surgical technique involved identification of the white line following dissection of the conjunctiva-M\u00fcller muscle complex. The levator was advanced using a double-armed 5-0 polyglactin suture along the anterior surface of the tarsus, exteriorized at a pre-marked point.Results: Twenty patients achieved optimal correction in terms of MRD1 and VPA, with normal lid contour and good lid-globe apposition. One eye was undercorrected, and one patient each exhibited medial notching and lateral flare. No patients developed postoperative lagophthalmos, ocular surface abnormalities, or discomfort. The overall success rate was 86.95%.Conclusions: Transconjunctival white line advancement is a significant modification in ptosis surgery with a short learning curve. The technique is easily reproducible, with a high success rate and excellent cosmetic outcomes.<\/jats:p>","DOI":"10.3341\/kjo.2025.0020","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T07:42:14Z","timestamp":1761637334000},"page":"21-27","update-policy":"https:\/\/doi.org\/10.3341\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aponeurotic Ptosis: A Retrospective Case Series of Transconjunctival White Line Advancement and Review of Literature"],"prefix":"10.3341","volume":"40","author":[{"given":"Pallavi Murthy","family":"Parashiva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruthi Tara","family":"Vasudev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saptagirish","family":"Rambhatla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1893","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1975.01010020601008"},{"key":"ref2","first-page":"34","volume-title":"Report of the chief operations performed at the Royal London Ophthalmic Hospital for the quarter ending 25th September 1857","author":"Bowman","year":"1859"},{"key":"ref3","first-page":"563","volume-title":"A new operation for ptosis with shortening of the levator and tarsus","author":"Blascovics","year":"1923"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.172353"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1952.00920010469011"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1961.01840020495005"},{"key":"ref7","first-page":"426","volume-title":"A new algorithm for ptosis repair using conjunctival Mullerectomy with or without tarsectomy","author":"Perry","year":"2002"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1975.01010020595007"},{"key":"ref9","first-page":"647","volume-title":"Modification of the M\u00fcller\u2019s muscle-conjunctival resection operation for blepharoptosis","author":"Weinstein","year":"1982"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/00002341-199106000-00005"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6700623"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.1976.tb00848.x"}],"container-title":["Korean Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ekjo.org\/upload\/pdf\/kjo-2025-0020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2025.0020","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekjo.org\/upload\/pdf\/kjo-2025-0020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T01:28:05Z","timestamp":1770946085000},"score":1,"resource":{"primary":{"URL":"http:\/\/ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2025.0020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.3341\/kjo.2025.0020","relation":{},"ISSN":["1011-8942","2092-9382"],"issn-type":[{"value":"1011-8942","type":"print"},{"value":"2092-9382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]},"assertion":[{"value":"2025-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}