Efficacy of autogenous fascia lata and silicone aurosling in correction of congenital blepharoptosis by frontalis suspension.

Purpose: The purpose of this study is to assess the outcomes of frontalis sling using fascia lata and silicone aurosling for congenital unilateral ptosis patients with poor levator function.

Material and Methods: Retrospective study of archival cases from 22 patients from author's center. All the patients with unilateral ptosis with poor levator function were included excluding those having poor Bell's phenomenon and associated pathology like jaw winking, 3rd nerve misdirection, squint, impaired corneal sensitivity, and neoplastic lesions. Patients were diagnosed based on the history and clinical examination including measurements. Corrections were performed by single surgeon. Marginal reflex distance-1 (MRD1) values observed preoperatively, immediate postoperatively, and late postoperatively in both groups.

Results: : Of the 22 cases, 12 were treated with fascia while the remaining 10 were treated with silicone aurosling material. The mean age of the fascia group was 11.42 ± 3.55 years while it was 14 ± 4.2 years for the silicone group. There were 10 males and 12 females in the study group. The mean follow-up in the study group was 20.14 ± 2.05 months, and the difference between the groups was not statistically significant. The difference between the two groups at the preoperative and immediate postoperative did not vary with statistical significance (P = 0.926 and P = 0.242, respectively). The late postoperative MRD1 did vary significantly between the two groups. The mean late postoperative MRD1 for fascia group was 3.67 ± 0.32 with a range of 3.1-4.15 while for the silicone group was 3.2 ± 0.46 with a range of 2.5-4. The difference was statistically significant (P = 0.023).

Discussion and Conclusion: The stability of the change in silicone aurosling group was relatively less as compared to the fascia lata. The recent material aspect study of such silicone aurosling material indicates that they are susceptible to damage and that cause the loss of stability. More studies with larger sample size and longer follow-up are needed.