AIM: To evaluate the effects and complications of levator shortening(LS)and frontalis myofascial suspension(FMFS)for the moderate and severe congenital ptosis.

METHODS: Totally 145 cases(188 eyes)with moderate and severe congenital ptosis were analysed retrospectively, hospitalized from January 2014 to December 2017. The clinical effect of both LS group(55 cases 71 eyes)and FMFS group(90 cases 117 eyes)were compared, and the complications of the two groups were observed.

RESULTS: The satisfaction rate, basic satisfactory rate and unsatisfactory rate of the two groups were no significant differences(U=-1.415, P=0.147)at postoperative 12mo. But in three different age groups analysis(<5, 5-10 and >10 years old group), FMFS group had the higher satisfactory rate(32.0% vs 8.7%)in <5 years old group(U=-2.244, P=0.025). Eleven eyes of 11 cases with conjunctival prolapsed only occurred in the LS group, 4 eyes of 4 cases with eyelid hematoma only occurred in the FMFS group. However, exposure keratitis, eyelid trichiasis, eyelid contour deformity and blepharoplasty separation occurred in both groups.

CONCLUSION: Both surgery methods have the good treatment effects on the moderate and severe congenital ptosis. FMFS has the higher satisfaction rate and the lower unsatisfactory rate in the infant <5 years old.