title: Comparison of cosmetic results in frontalis sling operations: the eyelid crease incision versus the supralash stab incision.
abstract: OBJECTIVE
  In addition to ptosis, the lack of eyelid crease is one of the main cosmetic problems of patients with poor levator function. In this study, we aimed to evaluate the effect of the incision site on ptosis correction and eyelid crease formation in frontalis sling operations.
  
  
  METHODS
  Photographs and charts of 27 patients (45 eyelids) who underwent frontalis sling operations were retrospectively reviewed. All patients had congenital ptosis with poor levator function ranging from 0 to 4 mm. In group I (15 eyelids), 3 supralash eyelid skin incisions were performed and the sling material was threaded along the tarsal surface. In group 11 (30 eyelids), the eyelid crease approach was used with the suturing of the sling material directly to the tarsus.
  
  
  RESULTS
  Although lid contour and lid crease symmetry were good in 46.6% of the cases in group I, eyelid crease formation was not satisfactory in any of the cases. Lid contour and lid crease symmetry were good in 76.6% of the cases in group II.
  
  
  CONCLUSIONS
  Our results indicated that the eyelid crease approach provided better functional and cosmetic results than did the supralash stab incision in frontalis sling operations. The passage of the sling material behind the orbital septum by direct visualization in the eyelid crease approach is one of the main factors affecting the surgical success of the frontalis sling operation.
authors.affiliation: Department of Ophthalmology, Ege University, School of Medicine, Izmir, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Yagci
authors.forename: Sait
authors.initials: S
authors.lastname: Egrilmez
mesh_terms: D000293:Adolescent; D016569:Blepharophimosis / Q000601:surgery*; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery*; D005206:Fascia Lata / Q000601:surgery; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D013577:Syndrome