Results of surgical techniques applied in blepharoptosis

Objective: Our aim was to analyze the success rates of patients who underwent levator aponeurosis or frontal suspension with silicone tube surgery due to blepharoptosis according to the elevator function (LF) and to compare our results with the literature. Material and Methods: We included twenty-five eyes of 47 patients who had levator aponeurosis or frontal suspension with silicone tube surgery in this study. The patients were grouped as good, moderate, and poor according to their LF. Good and moderate patients had levator aponeurosis while poor patients had frontal suspension with silicon tube surgery. The follow-up period after surgery was 2 to 36 months. The results were evaluated with margin reflex distance (MRD) which greater than 2 mm was considered as successful, between 1 and 2 mm was satisfactory, and less than 1 mm was unsuccessful. Also, patients required revision surgery was considered as unsuccessful. Results: Twenty-nine (61.7%) men and 18 (38.3%) women with a mean age of 35.16 years (range = 0-84 years) were included in this retrospective study. Thirteen cases (27.7%) had bilateral, and 34 cases had unilateral ptosis(72.4%). Eight of the 13 patients with bilateral ptosis had bilateral and 5 of them had unilateral surgery. Blepharoptosis was due to congenital (60.0%), aponeurotic (19%), traumatic (1.8%), Horner's syndrome (1.8%) and myotonic dystrophy (1.8%). The preoperative mean MRD value was 0.56 ± 0.85 mm (0-3 mm). The levator function (LF) was poor in 18 eyes (32.7%), moderate in 9 eyes (16.4%) and good in 28 eyes (50.9%). Thirty-seven patients (67.3%) underwent levator aponeurosis, and 18 patients had frontal suspension with silicon tube surgery. In our postoperative controls, 33 patients were considered as successful. Three patients were considered as satisfactory, and one patient was considered unsuccessful. Discussion: Levator aponeurosis and frontal suspension with silicone tube surgeries are both effective surgical methods to treat ptosis. Postoperative success is positively affected by determining the surgery method, according to LF. Our results showed that elevator aponeurosis surgery is more satisfying in good and moderate cases, and frontal suspension with silicone tube is best in poor cases.