Background: Blepharoptosis with poor levator function poses significant challenges, often necessitating surgical correction. Maximal levator resection focuses on maximizing residual muscle function to elevate the eyelid, while frontalis sling using silicone rods employs frontalis muscle action for eyelid suspension.
Aim: This study aimed to compare the surgical efficacy of using Maximal levator resection versus silicone rod sling in the management of Blepharoptosis with poor levator function.
Patients and Methods: This prospective randomized controlled study included 50 eyes with blepharoptosis and poor levator function who were submitted for surgical correction. Patients were randomly assigned into to 2 groups; Group 1: included 25 eyes who underwent Correction of Ptosis Using Maximal levator resection. Group 2: included 25 eyes who underwent Correction of Ptosis Using Tarso Frontalis Sling by silicone rod. Assessment of ptosis was done by the assessment of Margin reflex distance [MRD1], Palpebral fissure height [PFH], Levator function, Lid crease, Cover test, and Bell's phenomenon.
Results: Preoperatively, the mean PFH was significantly higher in group 2 [sling] than group 1 [MLR] [P = 0.04]. After 6 months the mean PFH was also significantly higher in group 2 [sling] than group 1 [MLR] [P = 0.001]. Preoperatively, the mean MRD 1 was comparable in both groups [P = 0.7]. After 6 months the mean MRD1 was significantly higher in group 2 [sling] than group 1 [MLR] [P = 0.01]. As regards the success rate, it represents 76% of the eyes in group 1 versus 84% of the eyes in group 2, with no statistically significant difference between the two groups.
Conclusion: MLR and FS with silicon rod have comparable surgical outcomes in terms of postoperative MRD1, PFH, Success rate, and complications.