Comparison of Two Methods for Upper Lid Fascia Lata Sling in Congenital Blepharoptosis: a Randomized Clinical Trial

To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function (< 4mm) were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling (modified Crawford method) and group B, monotriangular fascia sling (modified Fox method). This study included 30 upper eyelids (15 eyelids in each surgical group) of 19 patients (8 unilateral and 11 bilateral cases) with congenital ptosis. Mean increase in eyelid fissure height was 2.7±2.3 mm in group A and 3.4±2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant (P < 0.001, paired t-test) but intergroup difference was not (P=0.4, independent sample t-test). Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia.