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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.
Abstract:
The choice of surgery for congenital ptosis remains an ongoing debate. This study evaluated the efficacy and safety of levator-based versus frontalis-based surgeries, specifically focusing on ptosis with poor levator function. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library. Studies comparing levator-based and frontalis-based surgical techniques in congenital ptosis patients were included. Sixteen studies were included. Meta-analysis revealed no significant differences regarding postoperative marginal reflex distance 1 (MRD1) or change in MRD1 in poor levator function cases and overall pooled studies. Levator-based surgeries had lower risk of recurrence and implant- or suture-related complications. Postoperative lagophthalmos was comparable between the two groups. In conclusion, both levator-based and frontalis-based surgeries achieve satisfactory outcomes for congenital ptosis, including cases with poor levator function. Large, randomized trials with long-term follow-up are needed.
