Severe Congenital Blepharoptosis Research Articles

Tape Tarsorrhaphy in the Management of Lagophthalmos Caused by Severe Congenital Blepharoptosis Procedures.

Lagophthalmos, a common complication after blepharoptosis correction, has plagued oculoplastic surgeons. The goal of this study was to investigate the effect of tape eyelid closure on reducing the occurrence of lagophthalmos after blepharoptosis correction. From April 2020 to June 2021, a total of 112 patients with severe congenital ptosis received corrective surgery at the Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University. Of these, 48 underwent frontalis muscle advancement technique and 64 underwent conjoint fascial sheath suspension. Preoperative data collected included demographics, levator function, Bell's phenomenon, and marginal reflex distance 1 (MRD1). Postoperative data included surgery type, MRD1, eyelid closure function, aesthetic outcomes (including eyelid contour, eyelid symmetry, and eyelid crease), keratitis, and other complications. Frontalis muscle advancement technique group: the median of safe eye closure time was 7.3 months (positive Bell's phenomenon; interquartile range [IQR], 3.8-10.8 months) and 13.9 months (poor Bell's phenomenon; IQR, 11.6-16.1 months). There was a significant improvement between the preoperative and postoperative MRD1 (-1.52 ± 0.82 vs 3.85 ± 0.58 mm, P < 0.05). Conjoint fascial sheath suspension group: the median of safe eye closure time was 5.7 months (positive Bell's phenomenon; IQR, 2.9-8.5 months) and 12.4 months (poor Bell's phenomenon; IQR, 8.1-16.7 months). There was a significant improvement between the preoperative and postoperative MRD1 (-1.02 ± 0.91 vs 4.15 ± 1.03 mm, P < 0.05). All patients/guardians were satisfied with the aesthetic outcomes. Tape tarsorrhaphy is a safe, easy-to-learn method for treating lagophthalmos with a good aesthetic outcome.

"Extended Frontalis Muscle Advancement Technique for Severe Congenital Blepharoptosis".

The conventional frontalis muscle advancement technique still has some disadvantages, such as residual lagophthalmos, eyebrow ptosis, eyelid contour abnormality, and under-correction. This article describes the authors' extended frontalis muscle advancement technique that takes extensive subcutaneous separation through the eyelid crease incision for the treatment of severe congenital blepharoptosis. A retrospective review was performed that included patients with severe congenital ptosis who underwent extended frontalis muscle advancement technique from April of 2019 to April of 2021. Preoperative evaluation included age, sex, and margin reflex distance 1 (MRD1), levator function, and lagophthalmos. Postoperative evaluation including correction result, closure function of eyelid, cosmetic result was performed at the last follow-up. From April of 2019 to April of 2021, a total of 102 patients (137 eyes) who underwent extended frontalis muscle advancement technique were included in the study. The mean postoperative MRD1 in unilateral and bilateral ptosis patients was 3.84 ± 0.60 mm and 3.86 ± 0.56, respectively, and 126 eyes (92.0 percent) showed successful correction. Postoperatively, the mean residual lagophthalmos was 0.88 ± 1.40 mm, and 127 eyes (92.7 percent) showed excellent or good eyelid closure function. The average score of cosmetic results was 8.29 ± 1.34, and 94 patients (92.2 percent) had an excellent or good cosmetic result. Extensive subcutaneous separation relieves the mutual restriction between the forehead skin and frontalis muscle. The extended frontalis muscle advancement technique is effective in correcting severe congenital ptosis, while minimizing under-correction, residual lagophthalmos, eyelid contour abnormality and eyebrow ptosis. Therapeutic, IV.

Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different ages.

To evaluate the surgical outcomes of modified combined fascia sheath (CFS) and levator muscle (LM) complex suspension for the correction of severe congenital blepharoptosis in pediatric patients. Pediatric patients with severe congenital blepharoptosis were enrolled form July 2017 to July 2021. All patients were divided into two groups according to their age (group A ≤ 7 years; group B > 7 years) and received CFS + LM suspension surgery. Main surgical outcome indexes include margin reflex distance 1 (MRD1) and MRD1 regression. Postoperative complications such as lagophthalmos (LAG), conjunctival prolapse, exposure keratopathy and trichiasis were documented. Fifty patients (60 eyes) were enrolled, including 17 patients (18 eyes) in group A and 33 patients (42 eyes) in group B. The MRD1 in group A was 3.06 ± 0.64 mm at 6 months after the operation, and the MRD1 in group B was 2.64 ± 0.69 mm 6 months postoperatively which is significantly lower than that of group A (P = 0. 044). At the last visit, however, the MRD1 in group A was 3.00 ± 0.69 mm and the MRD1 in group B was 2.64 ± 0.70 mm. There was no significant difference in MRD1 between two groups in long term (P = 0.255). Additionally, there were a variety of degrees of MRD1 regression, especially in the first month after the operation in both groups (both P < 0.001). Moreover, there were 9 cases of postoperative complications in group A and 13 cases in group B. The overall occurrence of postoperative complications in group A was significantly lower than that in groups B (χ 2 = 4.413, P = 0.036). CFS + LM suspension, a modified CFS-based surgery, is an effective treatment for severe congenital blepharoptosis in pediatric patients. Moreover, CFS + LM suspension demonstrate excellent long-term outcomes, including good movement of the eyelid, satisfied eyelid closure and fewer postoperative complications.

Research on the expression of elastin in the conjoint fascial sheath for the correction of severe unilateral congenital blepharoptosis.

BackgroundTo investigate the expression of elastin in the conjoint facial sheath (CFS) in patients with severe unilateral congenital blepharoptosis in different age groups.MethodsTwenty-seven cases of severe unilateral congenital blepharoptosis (27 eyes) were treated with CFS + LM complex suspension from January 2020 to July 2020. Within that sample, 9 patients were over 18 years old, 9 patients were 13 to 17 years old and 9 patients were 5 to 12 years old. CFS and LM specimens were collected during CFS + LM complex suspension surgery. In the CFS specimens, the elastic fibers were observed by Victoria Blue staining. The elastin expression levels of the three groups of specimens were determined and analyzed by immunofluorescent staining and Western blotting.ResultsVictoria Blue staining showed that elastic fibers were abundant in CFS tissue. Moreover, immunofluorescent staining showed strong positive expression of elastin in the CFS and LM. Furthermore, in the child group, the Western blot results demonstrated that the expression of elastin was higher in the CFS than in the LM (P < 0.05). Additionally, the expression of elastin was significantly higher in the CFS of children than in that of adults or adolescents (P < 0.001).ConclusionsThe CFS and LM are rich in elastic fibers and elastin, although elastin expression in the CFS decreases with age. Thus, it is feasible to apply CFS + LM complex suspension to cure severe unilateral congenital blepharoptosis.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12886-022-02469-w.

The Combined Use of Silicone and Green Braided Polyester ‎Suture (Ethibond) versus ‎Silicone or Ethibond Alone for Frontalis ‎Suspension Surgery in Children.

PurposeThis study aimed to report the outcomes of correcting severe congenital blepharoptosis by frontalis suspension using combined silicone tube and 2–0 green braided polyester suture (Ethibond), and to compare the results with those of silicone rod alone and Ethibond suture alone.Patients and MethodsThe medical records of patients below 16 years who underwent frontalis suspension were retrospectively reviewed. Three groups of patients were identified; group I (16 patients: 22 eyelids) had frontalis suspension surgery using silicone suspension set, group II (18 patients: 25 eyelids) underwent the surgery using Ethibond suture, and group III (15 patients: 23 eyelids) was operated on using combined silicone and Ethibond suture. The primary outcome measures were postoperative marginal reflex distance-1 (MRD-1) and postoperative symmetry, and the secondary outcome measures were the occurrence of complications; mainly recurrence and wound-related complications. The follow-up data were collected after 1 week, 1 month, 6 months, 12 months and every 6 months thereafter.ResultsThe follow-up period ranged from 18 to 36 months. By the last follow-up visit, 13 eyelids in silicone group (59%), 11 eyelids in the Ethibond group (44%), and 13 eyelids in the double sling group (57%) achieved good surgical correction with MRD1 ≥3mm; these differences were not statistically significant. The difference in symmetry among the three groups was not significant. The highest rates of recurrence (44%) and wound-related problems (8%) were encountered in the Ethibond group, while the silicone group had no cases of wound-related problems. The lowest recurrence rate (26.1%) was in the double sling group but those differences were not significant.ConclusionCombined use of silicone and Ethibond suture in frontalis suspension surgery could offer lower recurrence rate and good final surgical outcome when compared to silicone rod or Ethibond suture alone.

Consensus on the diagnosis and treatment of blepharoptosis

Blepharoptosis is a symptom that is commonly observed in clinics. It presents with drooping of the upper eyelid and an asymmetric appearance of the eye. It can occur because of various causes. If left untreated, severe congenital blepharoptosis may impair visual function. The surgical approach largely depends on the severity of blepharoptosis, Bell’s phenomenon, and surgical history. However, it is intricate and difficult to achieve satisfactory symmetry and avoid complications. Owing to the complexity involved and discrepancies in treatment, we planned to arrive at a consensus on the diagnosis and correction of blepharoptosis among Chinese plastic surgeons and ophthalmologists, aiming to establish more standardized treatments and cause less harm to patients.

Maximal levator resection in congenital blepharoptosis

Objective The aim was to evaluate the surgical effect of maximal levator muscle resection technique for moderate to severe simple congenital blepharoptosis with poor levator function. Background Surgical treatments for the correction of congenital ptosis with poor levator function including frontalis suspension or maximal levator resection remain controversial. However, the levator resection approach seems to be the most physiological. Maximal levator resection, assuming that it is employed appropriately, is highly effective in cases of moderate to severe congenital ptosis with poor levator function. This surgery advances and plicates the levator muscle, thus increasing its effect. Patients and methods This prospective study included 29 eyelids of 20 patients who underwent maximal levator resection procedure, and their ages ranged from 3 to 8 years. Patients who presented with ptosis were examined and enrolled from January 2018 to January 2019, from the Outpatient Ophthalmic Clinic of Menoufia University Hospital. Follow-up was done at first week, first month, and sixth month postoperatively to evaluate the functional, cosmetic results, and complications. Results There is a statistically significant increase of mean postoperative marginal reflex distance-1 (MRD-1) at first week, first month, and sixth month in comparison with preoperative MRD-1 (P Conclusion Maximal levator resection procedure is very effective in the treatment of simple congenital blepharoptosis with poor levator function.

Mangament of Severe Congenital Blepharoptosis

Mangament of Severe Congenital Blepharoptosis

The inflammation influence on corneal surface after frontalis suspension surgery.

To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines. A prospective, observational case series. Thirty-one eyes of 25 patients with severe congenital blepharoptosis who underwent frontalis muscle flap suspension surgery with at least 6mo of follow-up were included in the study. The main outcome measures were margin reflex distance 1 (MRD1), degree of lagophthalmos, ocular surface disease index (OSDI), fluorescein staining (Fl), tear break-up time (BUT), Schirmer I test, and inflammatory cytokine assay. The degrees of lagophthalmos significantly increased after surgery. The OSDI scores significantly increased 1wk postoperatively and then decreased 4wk after operation. The Fl scores reflected corneal epithelial defects in sixteen patients at early stage postoperatively. The BUT and Schirmer I test values remained stable and did not show change compared to those before surgery. The inflammatory cytokines in conjunctival epithelial cells (including IL-1β, IL-6, IL-8, TNF-α, and IL-17A) significantly increased 1wk after the surgery (P<0.001), then returned to the normal level at 24wk postoperatively. The levels of inflammatory cytokine IL-1β, IL-6, IL-8, TNF-α, and IL-17A elevated significantly and were positively correlated with OSDI and Fl scores. Frontalis muscle flap suspension surgery results in lagophthalmos in early period of post-operation and relieved after months. The elevation of inflammatory cytokines level may participate in the occurrence of corneal epithelial defects at the early postoperative stage.

Clinical efficacy of frontalis muscle flap suspension with single incision of double eyelid for the correction of severe congenital blepharoptosis in children

Objective To evaluate the efficacy of frontalis muscle flap suspension with single incision of double eyelid for the correction of severe congenital blepharoptosis in children. Methods The data of 92 eyes of 64 children with severe congenital blepharoptosis from Jan. 2007 to Jun.2017 were retrospectively analyzed. All children were treated with the frontalis muscle flap suspension with single incision of double eyelid.They were followed up 3 - 6 months. Results In the early postoperative period all children had mild lagophthalmos, and they recovered to nomal in 1 month after surgery. At the last follow-up time, all cases got a satisfied efficacy with nomal palpebral fissure height and symmetric double eyelids. Efficacy was satisfactory in 83 eyes of 57 cases (90.22%), good in 9 eyes of 7 cases(9.78%) , and no inefficient case occurred. No complication occurred such as malformed upperlid fold deformity, entropion, ectropion, formix conjunctival prolapse, exposure keratitis or infection. Conclusion The frontalis muscle flap suspension with single incision of double eyelid is a safe and effective technique for severe congenital blepharoptosis in children with small injury and less complications.It can achieve good surgical results. Key words: Blepharoptosis, congenital, severe, children; Frontal muscle flap suspension, single incision, double eyelid

Comparison on the efficacy between combined fascial sheath suspension and frontalis muscle suspension for severe congenital blepharoptosis

Objective To compare the clinical efficacy between combined fascial sheath suspension and frontalis muscle suspension for the treatment of severe congenital blepharoptosis. Methods The data of 76 eyes of 60 cases with severe congenital blepharoptosis were collected.All cases were divided randomly into two groups.The observation group contained 39 eyes of 32 cases and control group 37 eyes of 28 cases.Observation group were treated with combined fascial sheath suspension, the control group underwent frontalis muscle suspension. The therapeutic efficacies of two groups were compared. Results In the observation group the effective rate was 92.30%, and in the control group was 89.20%. The difference between two groups was not significant(P=0.638). The rate of complication and recurrence in observation group were 10.25% and 2.78%; the control group were 35.14% and 18.18%.The difference were staristically significant(P=0.009, 0.034). Conclusion Combined fascial sheath suspension is an effective method for the treatment of severe congenital blepharoptosis. It can improve function of the upper eyelid, with little injury, less complication and low recurrence rate. Key words: Blepharoptosis, congenital, severe; Suspension surgery, combined fascial sheath, frontalis muscle

Changes of corneal tomography in patients with congenital blepharoptosis

The study aimed to evaluate the effect of drooped eyelid on corneal tomography in congenital blepharoptosis patients. Sixty-four patients with congenital blepharoptosis and 64 age- and sex- matched healthy subjects were included. According to the eyelid margin to corneal light reflex distance (MRD), eyes with congenital blepharoptosis were categorized as mild, moderate, or severe. The eyes were scanned using the rotating Scheimpflug camera. Increased topometric parameters were observed in moderate and severe blepharoptosis. Back corneal elevations at the thinnest point were significant higher for mild (P = 0.009), moderate (P < 0.001), and severe (P < 0.001) congenital blepharoptosis compared with controls. Maximum Ambrósio’s relational thickness (ART) was decreased in eyes with severe blepharoptosis (P < 0.001). Fnal D values were significantly higher in moderate (P < 0.001) and severe blepharoptosis (P < 0.001) groups than that of controls. There were significant correlations between MRD and most corneal tomographic parameters. Our findings indicated there was a trend toward subclinical keratoconus-like changes in the corneas of congenital blepharoptosis, with the increase of ptosis severity.

Suspension of Check ligament for the treatment of congenital severe blepharoptosis

To investigate the therapeutic effect of Check ligament suspension for congenital severe blepharoptosis. From Jan.2015 to Jan.2016,28 cases with severe congenital ptosis were treated by suspension of Check ligament to tarsus. The postoperative effect, curve of upper eyelid and complication were recorded. All the patients were followed up for 3-12 months. Complete correction was achieved in 24 cases, while undercorrection in 4 cases. Among the 24 cases with good results, they had symmetric palpebral fissure and natural curve of upper eyelid. Eye closure function recovered within 6 months in 19 cases. No complication, like corneal exposure, happened. Among the 4 cases with undercorrection result,2 underwent no further treatment due to marked improvement,2 underwent re-operation 6 months after the first operation with good result. Suspension can successfully correct severe congenital blepharoptosis with natural recovery of eyelid structure.

Evaluation of expanded polytetrafluoroethylene (Gore-Tex) suture in frontalis suspension in severe congenital upper-eyelid blepharoptosis

Aim The aim of the study was to evaluate the efficacy and complications of a new expanded polytetrafluoroethylene (Gore-Tex) suture in frontalis suspension in severe congenital upper-eyelid blepharoptosis with poor levator function (4 mm or less) wherein fascia lata is difficult to harvest in young children. Patients and methods In a retrospective study, frontalis suspension was performed in patients with severe congenital ptosis in whom the levator function was 4 mm or less. The procedure was performed in 62 eyes of 40 patients between February 2010 and March 2013. The mean follow-up duration was 12 ± 2 months. Forty patients were included in this study, 26 girls and 14 boys, with an average age of 2.8 ± 0.1 years. Frontalis suspension was performed with the open approach using a single pentagon suture (Fox procedure). Results The average margin reflex distance was −0.55 mm preoperatively, which improved to +2.2 mm at 6 months postoperatively ( P P = 0.005). Six eyes (10%) showed complete recurrence. Twenty-two eyes (35%) experienced partial recurrence. The average period of recurrence was 6.56 months. Postoperative complications such as suture granuloma, infection, exposure, lagophthalmus, and overcorrection occurred in a few patients. Conclusion The use of the new version of Gore-Tex suture as a suspensory material in frontalis suspension in severe congenital upper-eyelid blepharoptosis is safe and effective and can be recommended for clinical use.

Frontalis muscle transfer technique for correction of severe congenital blepharoptosis in Chinese patients: An analysis of surgical outcomes related to frontalis muscle function

The aim of this study is to evaluate the surgical outcomes related to frontalis muscle function using the frontalis muscle transfer technique in Chinese patients with severe congenital blepharoptosis and poor levator function. Between December 2003 and December 2011, using the frontalis muscle transfer technique, 37 patients of Chinese origin underwent surgery on 53 eyelids. The frontalis muscle function was assessed and categorized as poor (excursion≤7mm) and good (excursion>7mm) before the surgery. The results, including complications of the treatment procedure, were followed up and evaluated. Using the Cochran-Mantel-Haenszel statistic, the preoperative ptosis severity was compared with the degree of ptosis correction, and the preoperative frontalis muscle function was compared with the degree of ptosis correction using Fisher's exact test for paired data. A two-sided value of p<0.05 was considered statistically significant. Of the total eyelids considered, sufficient postoperative correction of ptosis was achieved in 43 eyelids (81.1%), while the correction was insufficient in 10 eyelids (18.9%). Fifteen (28.3%) eyelids were either overcorrected (n=5) or undercorrected (n=10). The rate of lagophthalmos was 3.8%. Eyelids with preoperative frontalis muscle function >7mm had a higher rate of sufficient correction in comparison to those with preoperative frontalis muscle function ≤7mm (91.2% vs. 63.2%; p<0.05). However, postoperative ptosis correction had no relationship with preoperative ptosis severity. The frontalis muscle is the main motor muscle used in the correction of severe blepharoptosis via the frontalis muscle transfer technique. Although the technique is considered to be an effective surgical method for the correction of severe blepharoptosis, the outcome of the correction procedure depends on the preoperative frontalis muscle function of the patient.

A new technique of check ligament suspension for severe congenital blepharoptosis

Objective To invastigate the clinical efficacy of check ligament suspension for severe congenital blepharoptosis. Methods Sixty-four eyes of 48 patients of severe congenital blepharoptosis were divided randomly into trial group, suspension of the eyelid to the check ligament(34 eyes of 24 cases); and control group, frontal muscle suspension surgery (30 eyes of 24 cases). The clinical efficacy was compared according to the condition of the palpebral height, eyelid margin radian, edema, palpebral fissure closure and lid lag after surgery. Results After following up for 6-24 months, eyelids were all raised and appearance was improved in both groups. In trial group, the edema was less, the eyelid was more natural and lid lag was less. In control group, 4 of the 24 patients were undercorrection, 1 patient's eyelid margin radian was not good and 1 patient got trichiasis. Patients in control group had more severe edema and obvious lid lag. Two patients' palpebral fissure closure was delayed. Lagophthalmos in 6 eyes still existed 6 months after surgery. Conclusion The suspension of the check ligament instead of musculi levator palpebrae superioris has reliable efficacy. The movement of upper eyelid is identical to the physical status, and the appearance of eyelids is more natural after surgery. Key words: Blepharoptosis, congenital, severe; Check ligament suspension

Modified palpabralis shortening surgery for complete congenital blepharoptosis

Objective To investigate the effect of modified palpabralis shortening surgery for congenital blepharoptosis. Methods A total of 38 eyes of 34 cases with severe congenital blepharoptosis received modified operation method of shortening palpabralis.The follow-up time was 3 to 36 months.The location of upper eyelid and the corneal conditions were evaluated. Results The surgical results were excellent in 34 eyes, and it were undercorrection in 4 eyes which received reoperation 3 months later.The complications of exposure keratitis, conjunctival prolapse or trichiasis was not found. Conclusion Modified palpabralis shortening can correct congenital blepharoptosis effectively. Key words: Blepharoptosis, congenital, complete; Shortening, muscle, levator, palpebrae superioris, modified

Improved sector frontal muscle flap suspension surgery for severe congenital ptosis

Objective To investigate the curative effect of modified sector frontal muscle flap suspension for severe congenital ptosis. Methods For severe congenital blepharoptosis, conventional suspension of frontal muscle flap was performed in 63 eyes of 50 cases, and modified sector frontal muscle flap suspension was performed in 63 eyes of 50 cases.The follow up time was 3 months to 1 year.The curative effect was observed and compared. Results In modified sector frontal muscle flap suspension group, the correction was good in 44 eyes (accounting for 69.84%), it was not enough in 19 eyes (accounting for 30.16%). The double eyelid formed well, and natural appearance was obtained in all patients. In traditional frontal muscle flap suspension group, the correction was good in 24 eyes (accounting for 38.10%), and was insufficient in 39 eyes (accounting for 61.90%). The double eyelid formed well in 23 eyes (accounting for 36.51%), the medial upper eyelid appeared entropion in 19 eyes, and the entropion was improved after secondary surgery. Hematoma formed in superior orbital region of palpebra in 18 eyes, and the hematoma was absorbed after cold compress and hemostatic treatment. Conclusion The modified sector frontal muscle flap suspension for severe congenital ptosis is effective, especially for patients with levator muscle strength less than 4 mm and frontal muscle strength more than 7 mm. Key words: Ptosis; Congenital; Frontal muscle flap, sector, modified; Suspension

Frontalis Muscle Flap Advancement for Correction of Severe Ptosis Under General Anesthesia: Modified Surgical Design with 162 Cases in China

Congenital blepharoptosis is a common pediatric disease. Frontalis muscle flap advancement is an effective surgical technique to treat patients with severe ptosis and poor levator function. However, since eye position changes under general anesthesia, it is necessary to adjust the position of the upper eyelid to achieve a better surgical outcome. A total of 162 children with severe congenital blepharoptosis underwent frontalis muscle flap advancement under general anesthesia. Patients were divided into two groups according to the different positions of eyelid suspension. The eyelid position of 82 children (96 eyes) in group A was adjusted to set at the superior limbus under general anesthesia, while the eyelid level of 80 children (94 eyes) in group B was adjusted according to the level labeled before anesthesia or the orthophoria level predicted using Krimsky's test. Lid level, ptosis recurrence, cosmetic appearance, and complications were evaluated 12 months after surgery. Excellent functional and cosmetic results were achieved in 61 (63.5 %) children from group A and 85 (90.4 %) from group B. Fewer complications were observed in group B (36.5 vs. 9.6 %). To achieve better surgical results after frontalis flap advancement for severe ptosis, it is necessary to adjust the eyelid level according to eye position changes that occur when the patient is under general anesthesia. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

First outcomes of silicon rod frontalis suspension prospective follow‐up in congenital blepharoptosis

AbstractPurpose Frontalis suspension is an efficient surgical solution for moderate to severe congenital blepharoptosis. Compared to autologous fascia lata, silicon rod allows faster surgery but long‐term results are still needed. Aim: to assess the long‐term results of silicon rod frontalis suspensionMethods This one year bicentric non‐comparative prospective study included ten patients who underwent frontalis suspension using silicon rod sling (FCI, France). The main criterion was the palpebral height measured before surgery and at one week, three months and one year postoperatively. Palpebral height was measured with Image J using a standardized technique on digital pictureResults The intermediate results are shown. The palpebral height was significantly improved in all patients at one week and three months compared to the preoperative values but tended to decrease between one week and 3 monthsConclusion The intermediate results show that silicon rod frontalis suspension seems an efficient method to treat congenital blepharoptosis. One‐year results are necessary to validate this outcome