ptosis surgery in patients with weak levator function using orbicularis oculi and frontalis muscles

purpose: to evaluate the outcomes of ptosis surgery in patients with weak levator function using orbicularis oculi and frontalis muscles. methods: this prospective interventional case series study was conducted over 3 years on patients with ptosis and weak levator function (less than 4mm). in all cases, orbicularis oculi and frontalis muscles were used directly to correct the ptosis. success was defined as upper lid margin to central corneal reflex distance (mrd1) equal or higher than 3 mm in bilateral cases and less than 1 mm difference between the two eyes in unilateral types. results: the study included 26 eyes of 22 patients with mean age of 15.4±9.4 years; 12 patients (54.5%) had a history of previous unsuccessful ptosis surgery. mean follow up was 13.5±8.4 months. the most common cause of ptosis was congenital which was present in 15 patients (68.2%). the operation was successful in 19 patients (86.4%). age and history of previous surgery was not correlated with success rate but the amount of levator function was directly correlated with success (p=0.02). conclusion: direct use of orbicularis and frontalis muscles to correct ptosis in patients with weak levator function can be a good substitute for other methods of surgery.