Abstract

Study Design: Prospective, Pilot
Purpose: Surgical repair of severe congenital ptosis is challenging as levator strengthening may be inadequate. Frontalis muscle is utilised in providing eyelid lift by transmitting the elevation to the tarsus using fascia lata or silicone sling, the conventional sling surgery. A newer procedure- the frontalis advancement flap is compared with silicone sling.
Methods: Treatment naïve patients undergoing ptosis surgery- silicone sling (SS) or frontalis advancement flap (FF) between July 2022 to January 2023. Outcomes were compared at 6 months.
Results: 8 eyes of 6 patients underwent FF and 5 eyes of 4 patients underwent SS. Baseline MRD1 was comparable. At 6 months, MRD1 was statistically comparable in both groups though the SS group showed a better trend (p=0.0705). Lid lag was present in 87.5% in FF and 100% in SS. Amount of lagophthalmos was lower in FF.
Conclusion: Frontalis advancement flap is comparable to silicone sling and has fewer side effects.

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