Direct tarsus to frontalis muscle sling without flap creation for correction of XXXX with poor levator function.

@entity1 @entity1736 @entity1410 @entity936
PURPOSE: To report the outcomes of @entity1736 surgery in @entity1 with weak levator function utilizing the direct tarsus to frontalis muscle sling technique without creation of a flap. METHODS: In a prospective nonrandomized case series over a 3-year period, @entity1 with @entity1736 and weak (less than 4 mm) levator function underwent direct sling of the tarsus to frontalis muscle without creating any flap. Success was defined as upper lid margin to central corneal reflex distance of at least 3 mm in bilateral cases and a difference of less than 1 mm in unilateral cases. RESULTS: Overall, 26 eyes of 22 @entity1 with mean age of 15.4        9.4 years were operated and followed up for 13.5        8.4 months. The @entity1736 was congenital in 15 @entity1 (68.2%) and acquired in 7 @entity1 (31.8%). Twelve @entity1 (54.5%) had a history of @entity1736 surgery. The procedure was judged as successful in 77.3% of @entity1 after initial surgery and in 100% after reoperation. Surgical success after initial surgery was directly correlated with the amount of levator function (P   =   0.02). However, success was not associated with age (P   =   0.9) or history of surgery (P   =   0.9). None of the @entity1 developed eyelid @entity1410 , lagophthalmus or @entity936 . CONCLUSIONS: Direct sling of the upper tarsus to the frontalis muscle without creation of flap is an effective procedure for correction of @entity1736 in @entity1 with weak levator function. Minimal dissection and preservation of the orbicularis oculi prevents lagophthalmus and its consequences.
