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Year : 2021  |  Volume : 14  |  Issue : 3  |  Page : 173-178

Maximal levator resection versus Gore-Tex® sling for congenital blepharoptosis with poor levator function

1 Department of Ophthalmology, The James Cook University Hospital, Middlesbrough, United Kingdom
2 Department of Oculoplastic Surgery, Research Institute of Ophthalmology, Giza, Egypt
3 Department of Ophthalmology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

Correspondence Address:
Dr. Ahmed Said Dawood
Department of Ophthalmology, The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ojo.ojo_127_21

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BACKGROUND: Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with those of frontalis suspension (FS) using Gore-Tex®, in the treatment of congenital blepharoptosis with poor levator function. PATIENTS AND METHODS: The study included 102 eyelids of 66 patients of mean age 4.3 ± 1.6 standard deviation (SD) years, randomly divided into two groups (51 eyes each). Group A: FS using Gore-Tex®, Group B: MLR. Postoperative outcomes were evaluated at 1, 6 and 12 months. Patients' ophthalmic examination including margin-reflex distance (MRD1) before and after surgery and postoperative complications were recorded. RESULTS: At the end of the follow-up, the mean MRD1 increased from 0.3 ± 0.7 SD mm in Group A, 0.4 ± 0.8 SD mm in Group B preoperatively, to 2.7 ± 0.5 SD mm and 2.9 ± 0.7 SD mm, respectively (P < 0.001 in both groups). Results of Group B were significantly higher than Group A (P = 0.047). Success was achieved in 77 eyelids (75.4%), distributed as follows: 36 eyelids (70.6%) in Group A, and 41 eyelids (80.1%) in Group B. The total recurrence rate was 6.9% (seven eyes), while other complications were recorded in 23 eyes (22.5%). CONCLUSION: MLR, compared to FS with Gore-Tex® sling, can be a more efficient surgical option to correct congenital blepharoptosis with poor levator excursion. Prominent postoperative lagophthalmos warrants close ocular surface observation in early follow-up weeks.

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