Treatment of Blepharoptosis in paediatric patients using modified frontalis sling technique with lid crease creation

Doi: 10.36351/pjo.v41i1.1910

Abstract

Purpose:  To observe the aesthetic and visual outcomes of a modified frontalis sling technique with lid crease creation in pediatric patients of upper lid drooping associated with weak Levator muscle.

Study Design:  Quasi experimental study.

Place and Duration of Study:  Al-Ibrahim Eye Hospital from January 2024 to June 2024.

Methods:  This study included pediatric patients (either gender) with congenital ptosis associated with weak Levator muscle. Preoperative eye examination and Ptosis examination including lid crease and fissure height, Levator muscle function, MRD-1, MRD-2, and Bell’s reflex were performed. All the registered patients underwent modified frontalis sling procedure with lid crease creation using silicon tube. Lid fissure and lid crease height and MRD-1 measurements were performed at I^st, 8^thand 24^th weeks after surgery. Pictures were captured both pre and postoperatively for comparison. Any side effect occurring during or after the procedure were also noted.

Results:  Six months after the procedure, 86% of patients showed desired results, with symmetrical eyelid appearance and negligible undercorrection (<1mm). Mean lid fissure height, lid crease height and MRD-1 were significantly increased (3.77±1.76 mm,3.20±0.51mm and3.23±1.65mmrespectively) after 6 months. Visual acuity was also improved. Minor side effects were observed only in few cases. Undercorrection of around 1mm occurred in 6 (13.95%) patients.

Conclusion:  Modified frontalis sling technique with lid crease creation using silicon tube has shown superior aesthetic and visual results along with less side effects in paediatric patients of upper lid Ptosis from birth.