Comparative Study of the Efficacy of Anterior Versus Posterior White Line Advancement Technique in the Correction of Primary Aponeurotic Ptosis

What this Trial Is About

This research aims to compare two surgical techniques, anterior and posterior white line advancement, for correcting primary aponeurotic ptosis in adults. The study seeks to determine if the anterior approach improves eyelid position, measured by Marginal Reflex Distance 1 (MRD1), better at 6 months than the posterior approach. It also evaluates differences in eyelid symmetry, contour, vision, and patient satisfaction between the two methods. Participants will be randomly assigned to one of two groups: one receiving the anterior approach involving a skin crease incision to access and advance the levator aponeurosis, and the other receiving the posterior approach, which uses a conjunctival incision without a skin cut. Both surgeries involve advancing the white line to the anterior tarsus using sutures. The study includes follow-up visits at 7 days, 2 months, and 6 months after surgery. During these visits, researchers will measure eyelid position and symmetry, evaluate eyelid contour using both software and masked evaluators, and test vision and tear film stability. Patients will also complete surveys on dry eye symptoms, scar quality, satisfaction, and psychosocial function. Surgical time and complications will be monitored. All images and data will be securely stored, and outcome assessors will be blinded to the group assignments for certain evaluations.

Anterior Versus Posterior White Line Advancement Technique in the Correction of Aponeurotic Ptosis