Background: Blepharoptosis is abnormal low position of the upper eyelid The effect of ptosis surgery on ocular surface is not clear and needs more clarification. Aim of this Work: To compare between levator resection and frontalis sling operations regarding tear filmand topographic changes in order to minimize postoperative morbidity and increase patient satisfaction. Patients and Methods: This study included 30 eyes of 27patients with moderate to severe ptosis and levator function within 5-6mmand with the ability to cooperate for examination and investigations. Patients were divided in a randomized manner into Two groups: Levator Resection (LR) group: 15 eyes of 15 patients underwent transcutaneous maximum levator resection. Frontalis Sling (FS) group: 15 eyes of 12 patients underwent frontalis suspension with silicon rods. The patients were subjected to complete ophthalmo-logical examination, special lid examination, tear film examination and corneal topography.
Results: In frontalis sling group, Schirmer test was constant in 53.3% of cases and increased in 46.7% of cases, On the other hand, Inlevator resection group, Schirmer test decreased in 86.7% of cases and was constant in 13.3% of cases with a statistically significant difference (p-value <0.001). Tear Break Up Time test (TBUT) decreased in 100% of frontalis sling group, however, it increased in 60% of levator resection group with a statistically significant difference (p-value <0.001). Topographic analysis revealed increase in topographic astigmatism in both groups with non-statistically significant difference (p-value 0.723).
Conclusion:
Frontalis sling operation adversely affects tear film quality but increases tear quantity. While levator resection decreases tear volume with improvement of tear film quality. Both operations increase topographic corneal astigmatism.