Frontalis muscle transfer technique for correction of severe congenital blepharoptosis in Chinese patients: An analysis of surgical outcomes related to frontalis muscle function.

AIM: The aim of this study is to evaluate the surgical outcomes related to frontalis muscle function using the frontalis muscle transfer technique in Chinese patients with severe congenital blepharoptosis and poor levator function.

MATERIALS AND METHOD: Between December 2003 and December 2011, using the frontalis muscle transfer technique, 37 patients of Chinese origin underwent surgery on 53 eyelids. The frontalis muscle function was assessed and categorized as poor (excursion ≤ 7 mm) and good (excursion > 7 mm) before the surgery. The results, including complications of the treatment procedure, were followed up and evaluated. Using the Cochran-Mantel-Haenszel statistic, the preoperative ptosis severity was compared with the degree of ptosis correction, and the preoperative frontalis muscle function was compared with the degree of ptosis correction using Fisher's exact test for paired data. A two-sided value of p < 0.05 was considered statistically significant.

RESULTS: Of the total eyelids considered, sufficient postoperative correction of ptosis was achieved in 43 eyelids (81.1%), while the correction was insufficient in 10 eyelids (18.9%). Fifteen (28.3%) eyelids were either overcorrected (n = 5) or undercorrected (n = 10). The rate of lagophthalmos was 3.8%. Eyelids with preoperative frontalis muscle function >7 mm had a higher rate of sufficient correction in comparison to those with preoperative frontalis muscle function ≤7 mm (91.2% vs. 63.2%; p < 0.05). However, postoperative ptosis correction had no relationship with preoperative ptosis severity.

CONCLUSION: The frontalis muscle is the main motor muscle used in the correction of severe blepharoptosis via the frontalis muscle transfer technique. Although the technique is considered to be an effective surgical method for the correction of severe blepharoptosis, the outcome of the correction procedure depends on the preoperative frontalis muscle function of the patient.