Effectiveness of the “sliding eight” technique for the treatment of upper eyelid ptosis

Abstract

OBJECTIVE: This study evaluated the effectiveness and reliability of suspension surgery using the "sliding eight" technique with a polypropylene thread in patients with severe upper eyelid ptosis over a long-term follow-up period. MATERIAL AND METHODS: The study included 107 patients (149 eyelids) with unilateral or bilateral congenital or acquired upper eyelid ptosis with poor or absent levator function (up to 5 mm). All patients underwent surgery using the "sliding eight" technique with a polypropylene thread. Postoperative assessment included MRD1, palpebral folds height, symmetry of these parameters between the two eyes, and the degree of lagophthalmos. RESULTS: Perfect symmetry of upper eyelid position in both eyes was achieved in 73 (68.2%) patients. In 34 (31.8%) patients, a difference in eyelid position was observed, averaging 1 mm. Asymmetry in the prominence of the palpebral folds was observed in 3 patients with bilateral ptosis. Repeat surgery was required in 11 (10.3%) patients. The mean follow-up period was 23 months. CONCLUSION: The "sliding eight" technique provides long-term, stable, and cosmetically favorable outcomes in the treatment of upper eyelid ptosis with poor levator function. The technique leaves virtually no visible traces and preserves eyelid softness throughout the follow-up period, while its atraumatic nature makes it possible to perform repeat surgery without damaging the surrounding tissues.