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Modified technique may improve results of frontalis suspension
Ophthal Plast Reconstr Surg. 2011;27(3):211-215.
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A technique modification to conventional frontalis suspension surgery may improve outcomes, according to a study.
Modifications included a direct eyelid crease incision and tarsal fixation, conservative fat removal blepharoplasty, lash margin rotation, and rhomboidal configuration with single midline brow incision.
A retrospective chart review included 171 eyelids of 93 patients who underwent modified frontalis suspension surgery over a 28-year period. Patient age ranged from 1 to 84 years, with a median age of 16 years. Mean follow-up time was 11.7 months.
Of 171 eyelids, 107 had congenital ptosis, 17 had chronic progressive external ophthalmoplegia, 14 had jaw winking ptosis, 12 had blepharophimosis, 10 had cranial nerve 3 palsy, nine had traumatic ptosis and two had myasthenia.
Results were gauged as excellent, good or poor. An excellent result was no more than 1 mm asymmetry in primary gaze and an eyelid position of no more than 2.5 mm below the superior limbus; a good result was an eyelid position of no more than 2.5 mm below the superior limbus; a poor result was residual ptosis with eyelid asymmetry.
Of the 93 patients, 89 (95.7%) had an excellent outcome. Six lids in four patients were under-corrected, no patients were over-corrected, and only two patients required a secondary bilateral frontalis suspension, one at the 2-year mark and one at the 3-year mark.