Ophthalmology Volume 114, Number 3, March 2007
A frontalis suspension sling procedure is considered the gold standard for the treatment of poor-function congenital ptosis, and a bilateral approach is recommended for the treatment of unilateral forms by most authors.
Advocates of bilateral surgery claim an improved symmetry during eyelid closure and blinking and in down gaze. On the other hand, bilateral surgery puts both eyes at risk of postoperative complications such as lagophthalmos, exposure kerathopathy, upper lid entropion, eyelash ptosis, absent eyelid crease, overhanging skin fold requiring blepharoplasty, and superior oblique palsy.2 In a recent article, Kersten et al reported a 95% rate of good to excellent results in a large series of patients affected by unilateral poor function ptosis who underwent a unilateral frontalis sling.
