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Related Experiment Video

Updated: Jan 12, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Levator-based versus frontalis-based surgeries for poor-function congenital ptosis: Systematic review and

Nada K Abdelsattar1, Taha Abd-ElSalam Ashraf Taha1, Ziad A Fadl1

  • 1Faculty of Medicine, Fayoum University, Al-Fayoum, Egypt.

Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society
|November 3, 2025
PubMed
Summary

Both levator-based and frontalis-based surgeries are effective for congenital ptosis, even with poor levator function. Levator surgery shows fewer recurrence and complication risks, but outcomes are comparable overall.

Keywords:
Congenital ptosisfrontalis-based surgerieslevator-based surgeriespoor levator function

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Area of Science:

  • Ophthalmology
  • Surgical Research
  • Pediatric Surgery

Background:

  • Congenital ptosis surgery choice is debated, particularly for cases with poor levator function.
  • Levator-based and frontalis-based surgical techniques are common interventions.

Purpose of the Study:

  • To evaluate and compare the efficacy and safety of levator-based versus frontalis-based surgeries for congenital ptosis.
  • To specifically analyze outcomes in patients with poor levator function.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, Scopus, Web of Science, Cochrane Library).
  • Included studies compared levator-based and frontalis-based surgical techniques in congenital ptosis.
  • A meta-analysis was conducted on data from sixteen selected studies.

Main Results:

  • No significant differences in postoperative marginal reflex distance 1 (MRD1) were found between surgical groups, overall and in poor levator function cases.
  • Levator-based surgeries demonstrated a lower risk of recurrence and implant/suture complications.
  • Postoperative lagophthalmos rates were similar in both surgical groups.

Conclusions:

  • Both levator-based and frontalis-based surgeries provide satisfactory results for congenital ptosis, including those with poor levator function.
  • Levator-based surgery may offer advantages in reducing recurrence and complication rates.
  • Further large, randomized trials with long-term follow-up are recommended to solidify findings.