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In severe blepharoptosis, surgical options can usually be divided depending upon the severity and extent of levator muscle function. In cases of poor levator muscle function, surgery with contraction of the frontalis is needed directly via the muscle itself or indirectly via an artificial material between the frontalis muscle and the tarsal plate. The frontalis sling technique has been considered the main procedure to treat patients with severe eyelid ptosis for decades [16]. Blepharoptosis correction under local anesthesia via frontalis transfer (local FT) can be an effective, but aggressive treatment [7]. However, if the patient is young or afraid of undergoing surgery, then surgery can be performed under general anesthesia (general FT). Silicone rod suspension surgery, a less invasive but effective treatment option, could be also performed under either general (general SS) or local anesthesia (local SS) [8,9]. The intraoperative eyelid level was adjusted until the eyelid margin covered 1.5 mm below the superior limbus of the cornea. Because the same surgeon performed all the procedures examined in this study, the effectiveness in correcting severe blepharoptosis was examined to assess whether the two operative options could be substituted for each other. In addition, the authors compare the effectiveness of the surgical options under both local and general anesthesia. Yong Jig Lee, David Dae Hwan Park

Frontalis Transfer and Closed Silicone Rod Frontalis Suspension