[Ptosis surgery in patients with weak levator function using orbicularis oculi and frontalis muscles]

ABSTRACT

To evaluate the outcomes of ptosis surgery in patients with weak levator function using orbicularis oculi and frontalis muscles. This prospective interventional case series study was conducted over 3 years on patients with ptosis and weak levator function [less than 4mm]. In all cases, orbicularis oculi and frontalis muscles were used directly to correct the ptosis. Success was defined as upper lid margin to central corneal reflex distance [MRD1] equal or higher than 3 mm in bilateral cases and less than 1 mm difference between the two eyes in unilateral types. The study included 26 eyes of 22 patients with mean age of 15.4 +/- 9.4 years; 12 patients [54.5%] had a history of previous unsuccessful ptosis surgery. Mean follow up was 13.5 +/- 8.4 months. The most common cause of ptosis was congenital which was present in 15 patients [68.2%]. The operation was successful in 19 patients [86.4%]. Age and history of previous surgery was not correlated with success rate but the amount of levator function was directly correlated with success [P=0.02]. Direct use of orbicularis and frontalis muscles to correct ptosis in patients with weak levator function can be a good substitute for other methods of surgery