Purpose: To assess the efficacy of sutureless sling surgery (triple S or SSS) in treatment of failed and complicated cases of previously operated congenital ptosis.
Methods: This modified simple technique of brow suspension was done for 15 eyes with congenital ptosis previously operated. This sutureless sling surgery (SSS or triple S) was performed for all the cases and was followed up for 3 months postoperatively. The outcome measures were patient satisfaction, cosmetic appearance, lid elevation and lid closure.
Results: A total of 10 patients (6 females and 4 males) with previously operated congenital ptosis with a mean age 12±4.1 years were included in the study. Seven eyes had a previous failed levator resection, 6 eyes had a previous complicated brow suspension surgery, 2 eyes of one patient had blepharophimosis syndrome with previous failed correction. Postoperative appearance was satisfactory for most patients with acceptable lid elevation and no lagophthalmos.
Conclusion: The triple S is a good attractive procedure to retreat the previously operated eyes with congenital ptosis. It has many advantages including simplicity, achieving best cosmesis (being sutureless), shortens the operative time and an easy learning curve.