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

Purpose: To compare the results of two different methods of upper lid sling withautogenous fascia lata in the treatment of congenital ptosis.Methods: In a randomized clinical trial, patients with congenital upper lid ptosis andpoor levator function ( 4mm) were randomly assigned to two different methods ofupper lid sling: group A, bitriangular fascia sling (modified Crawford method) andgroup B, monotriangular fascia sling (modified Fox method).Results: This study included 30 upper eyelids (15 eyelids in each surgical group) of 19patients (8 unilateral and 11 bilateral cases) with congenital ptosis. Mean increase ineyelid 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 ttest)but intergroup difference was not (P=0.4, independent sample t-test). Earlycomplications such as corneal epithelial defects and entropion, and late complicationssuch as undercorrection were comparable in the two groups. No patient experiencedrecurrent ptosis requiring reoperation in either group.Conclusion: The monotriangular method of upper lid fascia sling can be used insteadof the more popular bitriangular method. Advantages include less need for fascialtissue, less periocular scar formation and a shorter period of anesthesia.