Comparison of Outcomes of Suprabrow Single-Stab and 3-Stab Incision Frontalis Sling Surgery

This study aimed to compare functional and cosmetic outcomes of suprabrow single-stab (SBSS) versus conventional 3-stab incision frontalis sling surgery.

Comparative case series.

Twenty-one eyes of 17 patients for the study group and 21 eyes of 16 patients for the control group were included. All patients underwent thorough ptosis evaluation before surgery. Using Seiff silicone suspension set, the study group underwent SBSS, whereas the control group underwent suprabrow 3-stab surgery. The SBSS surgery modified conventional suprabrow 3-stab surgery by decreasing the number of suprabrow incisions to only a single one while still in the form of Fox pentagon.Functional outcomes were assessed in both groups using parameters like vertical fissure height, margin reflex distance 1, lagophthalmos, and lid closure. Vertical fissure height, lid crease height, lagophthalmos, symmetry of lids, and presence of scars were used to evaluate the cosmetic outcome of surgery. All patients were followed up for 15 months.

The study group and the control group were comparable at all points of time in functional outcome measures. On comparing the cosmetic outcomes, the study group fared significantly better than the control group (P = 3.092 × 10 in adults and P = 4.113 × 10 in children, Mann-Whitney U test), predominantly as a result of reduced scarring and fewer number of suprabrow scars.

The SBSS frontalis suspension technique, while retaining the usual advantages and functional results of standard sling procedures, is associated with decreased intraoperative bleeding, reduced postoperative edema and scarring, and a better aesthetic outcome.