Comparing Frontalis Sling Operation; Supralash Stab Incision versus the Eyelid Crease incision for the Treatment of Ptosis

Abstract

ongenital ptosis can present with loss of the peripheral visual field and loss of the central vision in severe cases. It can be associated with visual disturbances such as myopia, astigmatism, and anisometropia with subsequent amblyopia making early surgical correction necessary to avoid such sequelae. (102, 103) Ptosis can be corrected via multiple surgical procedures such as levator resection and advancement, slings, frontalis, and Whitnall, mullerectomy, and Fasanella-Servat. The choice depends on the degree of ptosis, the levator muscle function, as well as the surgeon’s experience. (2) Frontalis sling is reserved for patients with congenital ptosis and poor levator function (≤ 4 mm). This procedure involves creation of a link between the lid and frontalis muscle allowing better eyelid position in primary gaze and elevation of the eyelid by transmitting frontalis action to it. (79) Several sling materials are available such as fascia lata, whether autogenous or banked, or synthetic materials like PTFE (Gore-Tex), polypropylene, nylon, silicone, and mersilene. Synthetic sling materials are more readily available and are not associated with donor-site morbidity or cross-infection possibility. However, they are believed to have a