Purpose:The aiming was to study the long-term clinical outcome and the merit of the author's modification of the fox's procedure.Methods:Mersilene mesh brow suspension (MMBS) procedure was performed in 50 upper lids with severe blepharoptosis and poor levator function.Results:The improvement in lid height was evaluated by preoperative and postoperative vertical palpebral aperture measurements and ranged from 2 to 6 mm (average 4 mm). The functional and cosmetically accepted results were maintained in 94% of the lids during mean follow-up of 39.4 months.Conclusion:In the present non-comparative study we believe that late Mersilene knot extrusion and forehead granuloma formation can be prevented by the modification adopted by the authors.

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