[Treatment of severe ptosis by suspension of the upper eyelid using the autogenic frontal muscle and fascia lata. Analysis of 34 interventions].

The surgical procedure using frontalis muscle and autogenous fascia lata suspension (Beard, Crawford) gives good results in the correction of severe blepharoptosis. Personal experience of 34 operations (23 patients) is reported. The level of the palpebral margin remains stable and there is no long-term undercorrection. The autogenous fascia lata is, in our experience, better than the other sling procedures. There is good tissular adhesion and less necrosis. The disadvantages are the constant lid lag in downward gaze and the scar on the thigh. The lagophthalmos is well tolerated and needs neither drops nor ointments 3 months post-operatively. Complications were infection (1 case) and corneal ulceration in a patient with traumatic ptosis and complete ophthalmoplegia. The sling must be deep and must support the suspensor ligament of Whitnall without perforating the conjunctiva. This step requires the use of a Reverdin needle, and is controlled by a finger applied in the superior fornix.