Frontalis Sling Operation using Silicone Rods in Comparison to Ptose-Up for Congenital Ptosis with Poor Levator Function

Purpose: to compare the cosmetic and functional results of frontalis sling procedure using siliconerod with polytetrafluoroethylene (ptose-up) in congenital ptosis with poor levator function (lf)methods: in a prospective randomized study, 90 eyes of 66 patients with congenital ptosis thatunderwent frontalis suspension surgery [31 patients (18 unilateral, 13 bilateral cases) using asilicone rod and 35 patients (24 unilateral, 11 bilateral cases) using ptose-up] were included.follow-up time was 6 months. the preoperative and postoperative medical records andphotographs of patients and also their satisfaction were evaluated.results: the functional success rate was not significantly different between the two groups(p>0.05), but silicone material extrusion and infection was more frequent (although statisticallynonsignificant) in silicone rods group. the mean margin reflex distance (mrd1) at 1, 3, and 6months was 3.07 mm, 2.90 mm, and 2.61 mm in the silicone rods group, compared to 2.54 mm,2.37 mm, and 2.37 mm in ptose-up group. the results were significantly different between the twogroups at one and 3 months (p=0.018, 0.012, respectively), but at 6 months the difference was notsignificant. the patients’ satisfaction with the operation was significantly better in ptose-up groupcompared to silicone rods group [42%: good, 45%: moderate, 13% poor; and 71%: good, 14%:moderate, and 14%: poor, respectively (p=0.017)].conclusion: ptose-up is an excellent alternative to the silicone rod for the sling procedure, with agood success rate and acceptable complication rates compared to the silicone rod, and bettersubjective satisfaction of the patients.