Question

A child has ptosis and poor levator function. What surgery will you do?

• A. Levator muscle resection
• B. Mullerectomy
• C. Fasanella Servat surgery
• D. Frontalis suspension surgery

Answer 1

The Correct Option is D

The child presents with ptosis and poor levator function. In such cases, the appropriate surgical intervention is frontalis suspension surgery. This procedure is selected because:

• When the levator function is poor, typically less than 4-6 mm, surgeries that enhance the levator muscle such as levator muscle resection, Mullerectomy, or Fasanella Servat surgery are not effective.
• Frontalis suspension surgery involves connecting the eyelid to the frontal muscle using a sling material. This allows the child to use their forehead muscles to elevate the eyelid, compensating for the weak levator function.
• The goal is to improve vision and cosmetic appearance by lifting the eyelid to a normal position.