Modified Frontalis Sling Procedure with Lid Crease Formation

PURPOSE: To report the results of a modified frontalis sling procedure using Mersilene mesh for correction of upper lid ptosis associated with poor levator muscle function. METHODS: This interventional case series included 10 patients (15 eyelids) with congenital ptosis and poor levator function. All subjects underwent the upper lid sling procedure with modifications. Main outcomes were lid crease height and position. RESULTS: Overall, 15 eyelids from ten patients including 7 male and 3 female subjects underwent surgery. After a mean period of 10.2±2.8 months, all cases had symmetrical lid crease and contour; upper lid margin to corneal reflex distance and lid fissure were both increased significantly. CONCLUSION: This modified frontalis sling procedure may be considered as an alternative to conventional surgery; this method provides good cosmesis and is associated with a low rate of reoperations.