Open loop fascial sling for severe congenital blepharoptosis

Purpose: Severe congenital eyelid ptosis present as a functional and aesthetic problem. The choices of procedures depend mainly on providing an additional elevator force to the upper lid to elevate it, and maintain a reasonable eye opening and vision. We describe a simple open loop fascia lata suspension sling to the frontalis muscle to treat patients with sever eyelid ptosis and poor levator function. Methods: Sixty nine lids in 51 patients, were enrolled in this study, all had sever eyelid ptosis and had autogenous fascial sling used for the correction of the ptosis. Results: The final lid level and contour was evaluated after the follow-up period and showed that the results were satisfactory in 77% of the patients. The unsatisfactory results were due to under correction in 10%, poor lid crease in 6%, lid notch in 4%, and entropion in 3% of the operated lids. Conclusions: The accurate evaluation and implementation of this technique can correct the problem of ptosis provided that the patients exercises the frontalis muscle in order to accomplish the desired lid level. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.