AIM: To comparatively analyze the efficacy and clinical value of cutting frontal muscular slap or not during frontalis aponeurosis flap suspension in treating congenital severe ptosis.

METHODS: Clinical data of 44 children(54 eyes)with congenital severe ptosis treated in our hospital from May 2013 to October 2015 was retrospectively analyzed. Children included were divided into two groups according to the different ways of operation, observation group(cutting frontal muscular slap)and control group(without cutting frontal muscular slap), 22 cases(27 eyes)in each group. The general information, postoperative follow-up, eyelid closure and complication occurrence in two groups were compared.

RESULTS: The general information of the two groups had no statistical difference(P>0.05). After 1, 6mo, the cosmetic correction rate, the rate of overcorrection, and the rate of under correction in two groups had no statistical difference(P>0.05), but the activity of upper eyelid in observation group was bigger than that in control group(P<0.05). After 1, 6mo, the incomplete closure in two groups had no statistical difference(P>0.05), but eyelid fissure height in natural closed eyelids in control group was higher than that in observe group(P<0.05). After 1mo, 2 eyes in control group were with abnormal feelings in frontal part, and 3 eyes in observation group. After 6mo, 2 eyes in control group were with abnormal feelings in frontal part, and 3 eyes in observation group. There were no complications such as exposure keratitis, eyelid margin deformity, infection, hematoma, and diplopia in two groups.

CONCLUSION: The total therapeutic effects of two different surgery procedures in treating severe congenital ptosis are quite similar. The surgery with cutting frontal muscular slap could improve the activity of upper eyelid and postoperative eyelid closure.