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Commentary on: A Modified Approach to Transconjuntival Levator Advancement Offering Intraoperative Options.

The authors present an internal ptosis surgery approach with the advantages of avoiding a skin incision or resection, preventing alteration of the upper eyelid crease and fold— especially in Asian eyelids—and allowing intraoperative eyelid level adjustments to prevent over- and under-corrections. 1 They state that their procedure has advantages over Müller's muscle conjunctival resection (MMCR) procedure based on their more predictable outcome, that the phenylephrine test to determine the amount of MMCR cannot be relied on, and that a good algorithm for the MMCR is lacking.