Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Supramaximal Levator Resection vs. Modified Frontalis Muscle Flap in Severe Congenital Ptosis: A Prospective Comparison of Outcomes
Author: Altug Cetinkaya
ePoster Number: 245,00
Purpose
To compare the effectiveness of supramaximal levator resection (SLR) and modified frontalis muscle flap (mFMF) techniques in treating severe congenital ptosis with poor to absent levator function.
Methods
This prospective study included 48 eyes from 45 patients with congenital ptosis and poor levator function (≤4 mm), all operated on by a single surgeon (A.Ç.) between 2020 and 2025. Patients were stratified into two groups based on levator function: Group I (3–4 mm) underwent supramaximal levator resection (SLR); Group II (<3 mm) underwent modified frontalis muscle flap (mFMF) surgery. Surgical efficacy was evaluated using margin reflex distance (MRD) measurements and inter-eye symmetry (defined as a difference ≤1 mm). Postoperative outcomes were assessed at 1–3 weeks, 1–3 months, 6 months, and beyond 1 year. MRD values were analyzed using Generalized Estimating Equations, with statistical significance set at p<0.05.
Results
There were no significant differences between groups in age, gender, systemic comorbidities, or Marcus-Gunn jaw-winking syndrome. Group I comprised 35 eyes from 34 children; Group II included 13 eyes from 11 children. Mean follow-up was 1.89 ± 0.71 years in Group I and 1.3 ± 0.96 years in Group II. Both groups showed significant MRD improvement at 6 months (p = 0.001), with no inter-group difference (Group I: 3.32 ± 1.6 mm; Group II: 4.06 ± 1.0 mm). At final follow-up (>1 year), MRD difference from baseline remained stable and significant (Group I: 3.43 ± 0.9 mm; Group II: 3.79 ± 1.8 mm). Inter-eye symmetry with satisfactory contour was achieved in all cases. Revision surgery was needed in 11.43% of Group I, none in Group II.
Conclusion
Both SLR and mFMF significantly improved MRD with comparable functional and aesthetic outcomes. Results remained stable over long-term follow-up with no regression. The absence of revision in the mFMF group suggests greater long-term reliability and patient satisfaction. Both techniques are effective for managing severe congenital ptosis, with surgical approach determined by levator function.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Demet | Yabanoğlu | Hacettepe Üniversitesi, Ankara, Türkiye |
Abstract ID: 25-576
