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 silicone rod 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 that underwent frontalis suspension surgery [31 patients (18 unilateral, 13 bilateral cases) using a silicone 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 and photographs 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 statistically nonsignificant) in silicone rods group. The mean margin reflex distance (MRD1) at 1, 3, and 6 months 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 two groups at one and 3 months (P=0.018, 0.012, respectively), but at 6 months the difference was not significant. The patients’ satisfaction with the operation was significantly better in Ptose-up group compared 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 a good success rate and acceptable complication rates compared to the silicone rod, and better subjective satisfaction of the patients.