Latar Belakang: Blefaroptosis kongenital derajat berat dapat menghalangi aksis visual dan menyebabkan gangguan perkembangan sistem penglihatan, sehingga membutuhkan operasi untuk mengangkat kelopak mata. Saat ini, teknik operasi koreksi blefaroptosis dengan fungsi levator buruk di RSCM Kirana adalah frontalis sling dengan fascia lata dan reseksi otot levator maksimal. Saat ini berkembang teknik frontalis flap advancement dengan angka keberhasilan yang baik, namun belum diketahui aplikabilitas teknik tersebut di Indonesia.Tujuan: Menilai hasil tindakan dan keamanan tindakan frontalis flap advancement pada blefaroptosis kongenital derajat berat dengan fungsi levator buruk.Metode: Penelitian ini adalah studi quasi eksperimental dengan membandingkan keadaan sebelum dan sesudah perlakuan. Populasi target penelitian ini adalah seluruh pasien blefaroptosis kongenital derajat berat dengan fungsi levator yang buruk, berusia antara 8 hingga 40 tahun yang direkrut dengan metode purposive sampling. Pengukuran margin reflex distance-1 (MRD1), fisuka palpebra vertikal (FPV), fungsi otot levator (LA), dan pemeriksaan lapang pandang superior dengan mode superior 64 screening pada Humphrey Field Analyzer 2 dilakukan sebelum tindakan operasi. Selama tindakan operasi, dilakukan pencatatan durasi operasi, jumlah perdarahan, dan kesulitan yang dihadapi. Selama durasi follow-up selama 3 bulan, dilakukan pencatatan MRD1, FPV, dan lapang pandang superior pada setiap bulannya. Analisis statistik menggunakan perangkat lunak Statistical Package for the Social Studies (SPSS) v. 25Hasil: Dari 12 subjek penelitian, didapatkan median usia 17 tahun, median MRD1 -2 mm, FPV 5 mm, dan lapang pandang superior 0%. Tiga bulan pascaoperasi, didapatkan kenaikan median MRD1 (3 mm, p=0,003), FPV (9 mm, p=0,003), dan lapang pandang superior (92,2%, p=0,003). Simetrisitas kedua kelopak pasca operasi baik, dengan medium perbedaan MRD1 antara kedua kelopak sebesar 1 mm. Penelitian ini menemukan komplikasi pascaoperasi berupa ulkus kornea (1/12, 8,3%), hipoestesia frontalis (1/11, 9,1%), dan lagoftalmus (8/11, 72,7%).Kesimpulan: Teknik Frontalis flap advancement memiliki hasil tindakan dan keamanan yang baik pada blefaroptosis kongenital derajat berat dengan fungsi levator buruk.

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Background: Severe congenital blepharoptosis requires an appropriate surgery since the fallen eyelid may block the visual axis and hinder visual development. In RSCM Kirana, severe congenital blepharoptosis is corrected with either frontalis sling with fascia lata or maximal levator resection. Currently, frontalis flap advancement is considered to be an alternative technique with high success rate but the applicability of frontalis flap advancement in Indonesia is still unknown.

Aim: To evaluate the outcome and safety profile of frontalis flap advancement on severe congenital blepharoptosis with poor levator function.

Methods: This is a quasi-experimental study to evaluate the pre- and postoperative condition following frontalis flap advancement. The target population were individuals with severe congenital blepharoptosis aged between 8 and 40 years old, recruited via purposive sampling method. Margin reflex distance-1 (MRD1), vertical palpebral fissure (FPV), levator action (LA), and superior visual field examination using superior 64 screening mode in Humphrey Field Analyzer 2 were done prior to the operation. Duration of operation, blood loss, and difficulties faced were all recorded during the operation. During 3 months follow-up period, MRD1, FPV, superior visual field, as well as any complications found were recorded. Statistical analysis was done using Statistical Package for the Social Studies (SPSS) software v. 25.

Result: From 12 recruited subjects, the median age was 17 years old, median MRD1 was -2 mm, FPV 5 mm, and superior visual field 0%. Three months after the operation, we observe an increased MRD1 (median 3 mm, p=0,003), FPV (median 9 mm, p=0,003), and superior visual field (median 92,2%, p=0,003). Both eyelid had good symmetry untik 3 months postoperation with median difference of 1 mm. This study found several postoperative complications, which were corneal ulcer (1/12, 8,3%), frontal hypoesthesia (1/11, 9,1%), and lagophthalmos (8/11, 72,7%).

Conclusion: Frontalis flap advancement has a good outcome with low complication rate in patients with severe congenital blepharoptosis with poor levator function.