title: Comparing open and closed techniques of frontalis suspension with silicone rod for the treatment congenital blepharoptosis.
abstract: OBJECTIVE
  To compare open and closed methods of the frontalis suspension operation with a silicone rod in the treatment of congenital blepharoptosis.
  
  
  METHODS
  Forty-four cases with unilateral or bilateral congenital ptosis with a poor levator function of < 4 mm were divided randomly into two groups. Each group underwent an eyelid crease incision operation (open) or a supralash stab incision (closed). Ptosis was measured by the difference between the upper eyelid margin reflex distance (MRD) of the affected eyelids of the unilateral and bilateral cases. Frequent follow-up examinations were performed up to 12 months post-surgery.
  
  
  RESULTS
  Associated ophthalmologic findings showed that amblyopia, strabismus, wound discharge and knot dehiscence problems were present in 36.6%, 27.3%, 8.5% and 8.5% of the patients, respectively. There was no significant difference between the abovementioned associated ophthalmic findings of the two operative methods studied (P = 0.37). The difference in the surgical methods and MRD 3, 6 and 12 months after operation did not reach statistical significance. Similar results for good MRD (3 < MRD < 5) were found in closed (54.5%, 12/22) and open (54.5%, 12/22) methods, while 40.9% (9/22) and 45.5% (10/22) of cases were attributed to the under correction group in the closed and open methods, respectively. In bilaterally operated cases, MRD was more symmetrical than in unilaterally operated eyes. The symmetry of MRD and the eyelid crease was more prevalent in the open technique group.
  
  
  CONCLUSIONS
  The frontalis sling operation using a silicone rod exhibited better results, in terms of symmetry, in the open technique in comparison to the closed method.
authors.affiliation: Eye Research Center, Khatam-Al-Anbia Eye Hospital, Mashhad University of Medical Sciences , Mashhad , Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Etezad Razavi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khalifeh
authors.forename: Ahmad
authors.initials: A
authors.lastname: Yazdani
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005133:Eye Movements / Q000502:physiology; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D019919:Prosthesis Implantation; D012826:Silicone Elastomers; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D012826:Silicone Elastomers