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Clinical Outcome Comparison of Unilateral Levator Resection and Frontalis Sling for Unilateral Congenital Childhood Ptosis
Ann Optom Contact Lens 2018;17:5-9
Published online March 25, 2018
© 2018 The Korean Optometry & Contact Lens Study Society

Jun Myeong Yun, MD, Sung Eun Kim, MD, Suk Woo Yang, MD, PhD

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea Seoul, Korea
Correspondence to: Suk Woo Yang, MD, PhD
Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: 82-2-2258-1188, Fax: 82-2-599-7405
E-mail: yswoph@hanmail.net
Received February 19, 2018; Revised February 21, 2018; Accepted March 11, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To compare the surgical results of unilateral levator resection and frontalis sling in unilateral congenital ptosis patients.
Methods: Forty-eight patients with age < 15 years, who diagnosed with unilateral congenital ptosis and underwent surgical repair between January 2002 and December 2015 were included, and the authors retrospectively reviewed medical records of patients to compare the surgical results of 22 patients undergoing unilateral levator resection and 26 patients undergoing unilateral frontalis sling.
Results: The mean postoperative marginal reflex distance (MRD)1 were 2.09 ± 0.91 mm in the levator resection group and, 1.41 ± 1.18 mm in the frontalis sling group. Postoperatively, the mean MRD1 was significantly increased in both groups (p < 0.001). Successful results defined as MRD1 symmetry (the difference in MRD1 between the two eyelids ≤1 mm) were obtained in 19 patients (86.4%) of levator resection group (22 patients) and 12 patients (46.2%) of frontalis sling group (26 patients), success rate was significantly higher in levator resection group than frontalis sling group (p=0.004). In poor levator function group (Levator function test < 4 mm), MRD1 symmetry was obtained in 10 patients (83.3%) of levator resection group (12 patients) and 4 patients (36.4%) of frontalis sling group (11 patients), success rate was also significantly higher in levator resection group (p=0.021). Reoperation due to undercorrection was required in 3 patients (13.6%) of levator resection group and 12 patients (46.2%) of frontalis sling group, reoperation rate was significantly higher in levator resection group (p=0.015).
Conclusions: In children with unilateral congenital ptosis, It is considered that unilateral levator resection can provide better result and lower recurrence compared with unilateral frontalis sling.
Keywords : Congenital ptosis; Levator resection; Frontalis sling


March 2018, 17 (1)