Frontalis Slings With Palmaris Tendon as an Adjuvant Treatment for Myasthenic Blepharoptosis

Abstract

Ocular myasthenia (OMG) is a special form of general myasthenia gravis (MG), characterized by unilateral or bilateral ptosis. Although medical management remains the first line of therapy for the ocular manifestations of MG, the limitations of anticholinesterases and immunosuppressive therapy are well documented. We report one patient who did not achieve symptom control with medical therapy. The ptosis was corrected alternatively by bilateral frontalis slings with autogenous palmaris longus (PL) tendon. The eyelids were in good position 12 months postoperatively, with good eyelid closure. The surgical result has been stable for more than 2 years. For patients who have failed to respond to medical therapy for MG, frontalis sling procedure is an appropriate adjuvant treatment option.