Frontalis Transfer and Closed Silicone Rod Frontalis Suspension

ABSTRACT

BACKGROUND: Improvements in the degree of marginal reflex distance 1 (MRD1) were compared before and after use of the frontalis transfer (FT) method and closed silicone rod frontalis suspension surgery (SS) for severe blepharoptosis under general or local anesthesia with or without minimal sedation. METHODS: We reviewed the medical records and photographs of 76 patients who had visited our institute between 2006 and 2013 because of severe blepharoptosis with poor levator function and treated by the same senior doctor. RESULTS: In total, 104 eyes (63 patients) were included after applying exclusion criteria; 71 eyes (44 patients) were corrected using FT, and 33 eyes (19 patients) were corrected using the frontalis sling method with a silicone rod. Among the general FT, local FT, general SS, and local SS groups, the mean preoperative MRD1 was not significantly different. Postoperative MRD1 was highest in the local FT group. CONCLUSIONS: Both FT and SS positively increased MRD1, regardless of the anesthesia used; however, the change in MRD1 of the general SS group was the lowest (1.11+/-0.848 mm). Further, general FT, local FT, and local SS groups had an approximate 2 mm or greater increase in the differences between postoperative and preoperative MRD1. Specifically, the local FT group had a definite positive correlation with postoperative MRD1.