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Purpose: To evaluate the surgical outcome of a frontalis sling using deep temporal fascia in the treatment of severe congenital ptosis (SCP). Methods: A retrospective, interventional case series was performed. The study involved 25 patients with SCP (>4 mm). All patients underwent frontalis sling surgery with deep temporal fascia between 2004 and 2012 with a follow-up period of 12 months at a minimum. Data regarding eyelid position, eyelid symmetry, cosmetic outcomes, and postoperative complications were evaluated. Results: The mean age at surgery was 7.68 years (range 4–17 years) with an average follow-up of 60 months (range is 12–108 months). The functional success rate was 88% (22/25). Ptosis recurred in 8% (2/25) of patients, overcorrection was present in 4% (1/25) of patients. The patients with ptosis recurrence underwent reoperation. The preoperative margin-to-reflex distance (MRD1) was −0.85±0.87 mm (range, −2.5 to + 0.5 mm), while the postoperative MRD1 was + 2.1 ± 1.05 mm (range, −1.5 to + 4 mm) (p <.0001). Lid symmetry (asymmetry < of 1 mm of MRD1 between the two eyes) was present in all the successful cases. Postoperative complications included transient exposure keratopathy (32%) and inflammatory brow reaction (8%). Conclusions: Frontalis sling operation with deep fascia temporalis is very effective in the treatment of SCP with excellent long-term functional and cosmetic successes. [ABSTRACT FROM AUTHOR]

Background: Following the implementation of the SAFE strategy in Jigawa state, ophthalmic nurses trained as lid surgeons perform trichiasis surgery in the state. This study aimed to determine the early outcome of these surgeries with the specific objectives to determine the recurrence rate of trichiasis; the incidence of eyelid contour abnormality and incidence of eyelid closure defects 3-6 months postoperatively. Methods: A retrospective cohort study of patients operated for the first time between December 2012 and April 2013 in four zones in Jigawa state. Zones were selected based on the location of the most active surgeons. Patients were examined with torchlight for presence of recurrent trichiasis (TT recurrence), eyelid contour abnormality (ECA) and eyelid closure defects (ECD). Results: 133 eyes of 77 patients were examined; incidences recorded were TT recurrence 17.29% (95% CI 11.29-24.80%), ECA 18.93% (95% CI 12.64-26.67%) and ECD 5.3% (95% CI 2.15-10.62%). Incidence of poor outcome varied with zone and was associated with female sex, duration of symptoms >1 year preoperatively, bilaterally operated eyes, and paid surgery. Conclusion: The incidence of poor outcome measures was high across all zones evaluated. The risk factors associated with poorer outcome include late presentation, female sex, Bilateral surgery, and paid surgery. [ABSTRACT FROM AUTHOR]

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