AIM: To compare the outcomes of severe congenital ptosis treated with levator shortening and frontalis muscle flap suspension.

METHODS: Forty cases(58 eyes)with severe congenital ptosis were retrospective analyzed. Shortening levator muscle of upper eyelid was conducted in 30 eyes, and 28 eyes were treated with frontalis muscle flap suspension. All cases were followed up for 6mo. The ptosis correction rates were analyzed. Post-operative complications such as blepharelosis, hypophasis, exposure keratitis and conjunctival prolapse were recorded.

RESULTS: There was no statistically significant difference in the complete correction rate between levator shortening group and frontalis muscle flap suspension group(83% vs 82%, P>0.05). However, the levator shortening had better appearance and fewer complications, such as blepharelosis(0 vs 3), hypophasis(15 vs 23), exposure keratitis(1 vs 2), and conjunctival prolapse(2 vs 3)at 6mo after surgeries.

CONCLUSION: Both the operations are effective on the treatment of severe congenital ptosis. However, levator shortening surgery leads to fewer complications and better appearance.