• Zulfiquar Ali
  • Hasan Sajid Kazmi
  • Muhammad Khalid bin Saleem
  • Ashfaq Ali Shah


Background: Ptosis is an abnormally low position of the upper eyelid. Congenital ptosis should becorrected in early years of childhood. The aim of this study was to assess the efficacy andcomplications of frontalis suspension using silicon tube for simple congenital blepharoptosis with poorlevator function. Methods: A prospective study was performed on 33 children who underwent frontalissuspension using silicon tube from Jan 2008 to Jun 2011 with a minimum of 6 month follow-up.Functional success was defined when 3 criteria were met: (a) satisfactory lid height defined as marginto-reflex distance ≥3.5 mm with minimal frontalis action (brow up); (b) satisfactory lid symmetry (≤2mm asymmetry in margin-to-reflex distance) between two lids; and (c) satisfactory cosmesis, i.e.,normal lid contours. Results: The mean follow-up duration was 9 months (range 6.5–27 months). Thefunctional success rate was 91.4% (32/35 eyes). Three eyes had complications. In one eye (2.8%),recurrence of ptosis due to slippage of knot was seen, one eye developed infection of tract, and one withbilateral ptosis developed abnormal tenting of one of the lid. Conclusion: In simple congenital ptosiswith poor levator function, frontalis suspension using silicon tube has good efficacy and an excellentsafety profile. The results of frontalis suspension using silicon tube are comparable to fascia lata andsuperior to other non-autogenous materials.Keywords: Frontalis sling, brow suspension, congenital ptosis


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