Dr.Debraj Shome, Dr.Shilpa Taneja Mittal
Frontalis suspension with a silicone rod sling is the standard of care in patients with ptosis, having poor levator action.This gives decent cosmetic results, with the lid height of the operated eye being comparable to the normal eye. However, we found that our patients were still unhappy with the cosmetic results, despite the eyelid margin of the operated eye being at the same level as the normal eye.
We have modified frontalis suspension surgery by combining it with levator muscle extirpation, performed through an additional lid crease incision & this has been found to result in a more symmetrical upper lid crease, which in turn results in better cosmesis & greater patient satisfaction scores. This technique has now been by us used in over 200 patients – To the best of our knowledge, our RCT using this technique is the largest trial comparing cosmesis, using this technique. This modification should become the standard of care in frontalis sling surgery.