FRONTALIS SLING SURGERY USING SILICON ROD: RESULTS IN CONGENITAL UNILATERAL PTOSIS AMONG NORTH INDIAN POPULATION

Purpose: To evaluate the results after frontalis sling surgery in congenital unilateral ptosis. Methods: This was a prospective study which included 27 eyes of patients with congenital unilateral ptosis and fair to poor levator action (<8mm). A complete examination was performed including palpebral fissure height and width, lid-crease distance, margin reflex distance 1 (MRD 1) and margin reflex distance 2 (MRD 2), levator function. Fox pentagon technique was employed using silicon rod. Follow up was done at 2 weeks and at 3 months and based on the criteria recommended by Tarbet et al, the ptosis correction was catergorized into: ‘excellent’ if MRD1 measured more than 2mm or the difference in MRD1 between two eyelids was equal to or less than 1 mm, ‘good’ if MRD1 ranged from 1 to 2mm or if asymmetry was 1.5 to 2mm, and ‘poor’ if MRD1 measured less than 1 mm or if asymmetry was greater than 2mm in primary position of gaze. Results: A total of 27 eyelids of 27 patients underwent frontalis sling surgery with silicon rod. The correction was excellent in 20 patients (74%) on both first and second follow-up visits, shown in fig1. It was good in 5 patients (19%) and poor in 2 patients (7%) based on the above mentioned criteria. Lagophthalmos was present in all patients postoperatively which improved with time. Conclusion: This study shows that surgical repair using silicone sling is a safe and effective method of correcting congenital ptosis with poor to fair levator function.