Repair of ptosis using frontalis muscle and fascia lata: a 20-year review.

The results of an analysis of the surgery ("Repair of Ptosis using Frontalis Muscle and Fascia Lata") carried out on 316 lids is presented. The main indication for this operation is a large congenital ptosis with minimal levator function. Conclusions from the study indicate that autogenous fascia is an ideal tissue for lid suspension, and is better than stored fascia. Stored fascia does present some problems but is useful in small children or when the patient does not want a scar on the leg. Bilateral repair for unilateral ptosis is recommended for symmetrical results. The best ages for surgery is between 3-1/2 and 6 years of age, as these young corneas rapidly adapt to the exposure problems. It is very important to check the corneal sensation before carrying out the surgery. When this operation is done on older patients with acquired ptosis, e.g. ptosis associated with myasthenia gravis, corneal exposure problems frequently result.