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Surgical outcomes of tarsofrontalis sling surgery using silicon rod versus supramaximal levator resection in unilateral congenital ptosis with poor levator function

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Abstract

Purpose

To compare the surgical outcomes of tarsofrontalis sling surgery using silicon rod versus supramaximal levator resection in patients of unilateral congenital ptosis with poor levator function (≤ 4 mm).

Materials and Methods

This randomized control study was conducted over a period of 18 months. 44 patients were enrolled in the study group. The study population was randomly divided into two groups (22 in each group). In Group A, congenital ptosis was treated with tarsofrontalis sling surgery using silicon rod and supramaximal levator resection was done in the group B. Follow-up examination was done at postoperative day 1, one week, 1 month, 6 months and 12 months. Surgical outcome measures were change in marginal reflex distance-1 (MRD 1), vertical palpebral fissure height (VPFH) and inter-eyelid difference of margin reflex distance 1 and complications in two groups.

Results

The mean age of patients in group A was 7.25 ± 6.10 years ranging from 1–18 years and mean age of patients in group B was 5.64 ± 2.44 years ranging from 3 to 11 years. Good surgical outcome was obtained in 73–77% of both groups. MRD1and VPFH increased significantly after surgery from baseline in both the groups (p value < 0.001). Inter-eyelid MRD 1 difference also improved significantly in both groups following ptosis surgery.

Conclusion

Both supramaximal levator resection and tarsofrontalis sling surgery are equally effective in cases of unilateral ptosis patients with poor levator function and should be part of the surgical armamentarium for treating congenital ptosis.

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Funding

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Authors and Affiliations

  1. Army Hospital Research and Referral, New Delhi, 110010, India

    Sonali Vinay Kumar, Siddharth Goel, Alok Sati & Sanjay Kumar Mishra

  2. Venkateshwara Institute of Medical Sciences, Gajraula, New Delhi, Uttar Pradesh, 110010, India

    Vinay Kumar

Authors
  1. Sonali Vinay Kumar
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  2. Siddharth Goel
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  3. Vinay Kumar
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  4. Alok Sati
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  5. Sanjay Kumar Mishra
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Contributions

Conceptualization: [SVK,SG,VK]; methodology: [SVK,AS]; formal analysis[SVK,SKM]; writing–original draft preparation;[SVK,SG,VK]; writing–review and editing:[SVK,SKM,AS];supervision; [SKM].

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Correspondence to Sonali Vinay Kumar.

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The authors have no relevant financial or non- financial interests to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional reserch committee (Army Hospital Research & Referral) and with the 1964 Helsiniki Declaration and its amendments or comparable ethical standards. This manuscript did not involve any kind of animal research. All the authors consent to the publication of this manuscript in International Ophthalmology.

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Kumar, S.V., Goel, S., Kumar, V. et al. Surgical outcomes of tarsofrontalis sling surgery using silicon rod versus supramaximal levator resection in unilateral congenital ptosis with poor levator function. Int Ophthalmol 43, 957–964 (2023). https://doi.org/10.1007/s10792-022-02497-x

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  • DOI: https://doi.org/10.1007/s10792-022-02497-x

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