Combined Technique for Severe Ptosis
Author: MEHDI FENDRI
Base Hospital / Institution: Taoufik Hospital Group ( THG )
Rapid fire oral presentation
Abstract ID: 24-518
Purpose
Several techniques have been proposed for severe congenital ptosis, but many remain controversial. We propose a combined technique that can be effective and provide stable results with a minimum of complications.
Methods
The combined technique involves a Whitnall sling (WS) in conjunction with a frontalis muscle flap (FMF) for severe congenital ptosis in a single procedure. We compared the results and complications between the combined technique, the Whitnall sling alone on one side, and the frontalis muscle flap alone on the other side.
Results
We evaluated 32 patients (39 eyes). Thirteen patients (15 eyes) were operated on with the combined technique, 16 patients (21 eyes) had a Whitnall sling alone, and 3 patients (3 eyes) had a frontalis muscle flap alone. With a follow-up of one to two years, we observed a 0.06% surgical revision rate for the combined technique (WS+FMF), compared to 19% for the WS alone. For the FMF alone, there were no cases of surgical revision. Regarding complications, in the FMF alone group, there were two cases out of three with anterior traction and eyelash malposition; whereas with the combined technique, no such cases were observed. For all patients with FMF (both combined and single procedures), we observed 26% with frontalis hypoesthesia and 0.06% with upper eyelid deformity
Conclusion
The combined technique for severe ptosis provides more stable results than the WS alone and, at the same time, avoids the risk of anterior traction and eyelash malposition associated with the FMF alone.
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