A modified silicone frontalis sling for the correction of blepharoptosis.

We devised a frontalis sling by using two No. 40 silicone bands. Each free end was sutured to the tarsus and joined in the central brow area. We used pulley sutures in the medial and lateral brow incisions to prevent migration of the bands. With this method, adjustment of the eyelid level can be made anytime postoperatively through the central eyebrow incision because of the ease in finding the overlapped ends of the silicone bands. This is particularly useful for patients with chronic progressive ophthalmoplegia where poor closure and exposure keratopathy are potential postoperative problems.