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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.
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.
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.
