Abstract
Introduction Frontalis suspension surgery (FSS) is the established surgical treatment for severe ptosis. Limitations of this technique includes need for patient engagement to raise the eyelid, oedema and infection at the incision sites, as well as facial scarring. This study carries out an anatomical investigation into an alternative surgical approach which aims to minimise these limitations.
Aims To carry out a cadaveric demonstration of surgical techniques, comparing FSS to an alternative approach.
Methods A fresh frozen cadaveric head specimen was used to demonstrate the FSS procedure and the alternative approach. Outcomes were recorded by photographs. This included the post-operative palpebral fissure height (PFH), as well as the capacity for the eyelids to close post-operation. The aesthetic outcome of both procedures was also analysed.
Results The proposed surgical technique and the FSS method both achieved a post-op PFH measurement within the normal range at 7mm following procedures. The study also demonstrated that the proposed technique allowed for full eyelid closure against the retracting tension of the sling. The aesthetic outcome of the proposed surgical method was superior to the FSS technique by achieving a natural eye contour while eliminating brow incision scars.
Conclusion The study presents a successful cadaveric demonstration of a novel surgical procedure for treatment of severe ptosis. This procedure offers resolutions for multiple adverse effects of FSS, as well as functional and aesthetic limitations. However, the higher risk of lagophthalmos is an anticipated concern. This requires further research into the mechanical compatibility of this technique in vivo.
