Abstract

Aim: is to compare between the outcome and complications in the use of local and general anesthesia in the management of sever blepharoptosis by use of straight needle threading technique and silk suture as a frontalis suspension.
Settings and Design: it’s a prospective comparative study using two group one under local anesthesia and the other under general anesthesia with standardization of the cases as all has sever ptosis and poor levator functions, technique as the straight needle threading technique was used, material of thread was silk in 92% of cases, and sex distribution was of no statistical significance.
Methods and materials: The parameters used for comparison were the following:-Satisfaction, Correction, Symmetry, Lid crease height (visible pretarsal height), Infection, stich abscess, stich granuloma, Eye opening during sleeping, Lagophthalmus, Entropion, Exposure keratitis. A 120 eye was operated on 95 patients; 25 patients (50 eyes) bilateral, 70 patients (70 eyes) unilateral, 36 eyes (30%) were operated on under local anesthesia, and 84 eyes (70%) were done under GA. The minimal age was 2years, maximum age 75 years, median 12 years, mean 19.8 years. The patients above the age of 16 years old were asked to choose between local or GA while below that age the correction was done under GA only.
Results: There was no statistical significant difference in the all the nine parameters except the eye opening during sleeping were higher in the general anesthesia group.
Conclusion: The use of local anesthesia is easier, of less risk, and lower cost with same aesthetic results of general anesthesia.