Broad fascia fixation enhances frontalis suspension.
OBJECTIVE
To report the use of a modified frontalis suspension procedure for congenital ptosis patients with minimal to no levator function.


METHODS
Retrospective, non-comparative case series of frontalis suspension by 2 surgeons over a 21-year period.


RESULTS
Frontalis suspension with broad fascia fixation was performed on 48 eyelids of 25 patients. All patients had visual obscuration due to blepharoptosis with only 0 mm to 2 mm of measurable levator function. Age ranged from 3 to 13 years. Minimum length of follow-up was 6 months (range, 6-174 months). The palpebral fissure was increased in all patients, improving their head position and unmasking their visual axis in primary gaze. Postoperatively, all patients developed transient exposure symptoms. There were no migrations, extrusions, infections, or granulomas. All patients achieved a satisfactory postoperative result based on eyelid position, function, and contour.


CONCLUSIONS
This modified frontalis suspension procedure maximizes frontalis muscle recruitment, creating powerful eyelid elevation with stable effect over time. The technique minimizes other procedures' pitfalls and advances in cosmesis are achieved with enhanced eyelid crease formation and adjustable eyelid contour.
DeMartelaere
Sheri L
SL
Texas Oculoplastic Consultants, Austin, Texas 78705, USA.
Blaydon
Sean M
SM
Cruz
Antonio Augusto Velascoe
AA
Amato
Malena M
MM
Shore
John W
JW
D001763:Blepharoptosis / Q000151:congenital* / Q000601:surgery*; D002648:Child; D005143:Eyelids / Q000601:surgery*; D005206:Fascia Lata / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies