Complications of fascia lata harvesting for ptosis surgery

Wheatcroft, S; Vardy, S J; Tyers, A G

doi:10.1136/bjo.81.7.581

Cited by 105 publications

(64 citation statements)

References 8 publications

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“…9,10 The mesh is inexpensive, easy to prepare and work with, and can be sterilized easily. Since fascia lata is poorly developed in young children and there are problems 11,12 associated with its harvest, we have been using this material for brow suspension procedures in children undergoing ptosis surgery. We present our experience over the last 10 years (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of ptosis correction using Mersilene mesh

Sharma

Willshaw

2003

Eye

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The preferred operation for correction of severe ptosis with minimal levator function is a brow suspension procedure. Owing to the poorly developed fascia lata in young children, and concerns about the side effects of harvesting fascia, we have, for many years, used synthetic Mersilene mesh as our suspending material. We present our experience with this material over the last 10 years. We have undertaken a retrospective analysis of the case notes of all patients undergoing brow suspension surgery, using Mersilene mesh, from 1990 to 1999. Functional and cosmetic success was recorded with respect to long-term stability. Data from 41 patients (71 lids, 30 bilateral and 11 unilateral procedures) were analysed. The minimum follow-up period was 12 months with a mean of 38.4 months (SD 23.3). We found a long-term stability of ptosis correction in 67/71 (94.4%) procedures (38/41 (92.7%) of patients). Parental satisfaction was achieved in 90.1% (64/71) of procedures or in 85.4% patients (35/41). Four lids (5.4%) of three patients (7.4%) required further surgery. Mersilene mesh is a safe and convenient suspensory material for brow suspension in young children, and provides good long-term results with a low complication rate.

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Section: Introductionmentioning

confidence: 99%

Long-term follow-up of ptosis correction using Mersilene mesh

Sharma

Willshaw

2003

Eye

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“…2,3 The fascia lata is not well developed before the age of 3 years making the harvest of adequate fascia technically challenging. Thigh scars stand out more obviously in young children [1][2][3]6,22 making it unappealing to most parents. Complications related to AFL harvesting such as muscle herniation and haematoma occasionally occur.…”

Section: Discussionmentioning

confidence: 99%

Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report

Chong

Fan

Lai

et al. 2009

Eye

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Purpose To assess surgical, visual, refractive, and aesthetic outcomes 13 years after mersilene mesh frontalis sling (MMFS) operation for severe unilateral congenital ptosis performed in 10 infants before 1 year of age. Methods Longitudinal follow-up of an interventional case series by structured ocular examinations, external photographs, and questionnaire-based interviews.Results Mean age at surgery was 6.9±2.7 months. After a mean follow-up of 13.0±0.6 years, one patient (10%) had recurrent ptosis with the upper lid 2 mm below the superior limbus at 3 months postoperatively. Best-corrected visual acuities were within two Snellen lines between the two eyes in all patients. Astigmatic errors were 1.20±1.00 D and 1.10±1.70 D between operated and unoperated eyes. Four patients had 2 mm lid lag on down-gaze and one of them had 2 mm lagophthalmos. Mean satisfaction scores (scale of 1 to 100) for lid position, cosmesis, function, and to the procedure were 83.3 ± 11.8, 77.0±22.9, 89.4±5.5, and 86.8±6.3, respectively. No case of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy was noted. Conclusions In view of the low recurrence rate (10%) and absence of serious complication or need for revision after 13 years, the use of MMFS seems effective and feasible in infants less than 1 year old. Achieving compatible long-term stability, satisfactory aesthetic, and visual outcomes, MMFS may offer an alternative to delaying operations for autogenous fascia lata harvesting in infants requiring early ptosis correction.

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“…Autogenous fascia lata is the most appropriate material for the use in frontalis suspension, but there are insufficient amounts of this material in children younger than 3 years of age. Donor fascia lata provides a reasonable alternative that decreases the attendant morbidity and reduces the complexity of the procedure [16,26,27] . When fascia lata is not available, whether autogenous or donor, synthetic materials can be used.…”

Section: Resultsmentioning

confidence: 99%

Outcome of Y to V Medial Canthoplasty With Medial Canthal Tendon Plication for the Correction of Blepharophimosis- Ptosis-Epicanthus Inversus Syndrome

Elbakary

2015

International Journal of Ophthalmic Research

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CONCLUSION:The two stages management using simple procedures as Y to V medial canthoplasty with MCT plication followed by frontalis suspension or maximum levator resection yielded satisfactory results in the correction of complicated deformity as BPES. INTRODUCTIONBlepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is an uncommon congenital disorder characterized by a narrowed horizontal palpebral aperture, ptosis, epicanthus inversus, and telecanthus. It typically has bilateral features, although not always symmetrical [1,2] . This syndrome is inherited as an autosomal disease, but also can be manifested as a result of new genetic mutations and sporadic cases without family history of the disease can occur. Several studies confirmed the presence of mutations such as deletion or translocation of the FOXL2 gene, which maps to chromosome 3q21-24 [3,4] . Surgical treatment for BPES is one of the most complex in the field of eyelid surgery due to the presence of multiple deformities. Many surgical techniques have been described to address the epicanthus inversus and accompanying telecanthus including Y to V flaps, the Mustarde technique, the 5-flap technique, medial canthal tendon shortening or plication, and transnasal wiring, and none of them is free from criticism [5][6][7][8][9] . Some authors recommended that medial canthoplasty should be performed first followed by ptosis correction, while others recommended one stage. Therefore, there is no unanimous consensus on BPES correction with respect to either MATERIALS AND METHODS:Prospective interventional case series which included 15 cases of BPES. Two stages management was used in all cases. The first stage was Y to V medial canthoplasty with MCT plication. 3 months later, ptosis was corrected by bilateral frontalis suspension or maximum levator resection in the more ptotic eyelid in patients with asymmetric ptosis. Data regarding margin reflex distance 1 (MRD1), horizontal palpebral fissure length (HPFL), inner intercanthal distance (IICD), and the ratio of IICD to HPFL were recorded before and after surgery and were statistically analyzed. Post operative IICD/HPFL ratio of 1.5 or less was considered successful outcome. RESULTS: The mean age of patients was 3.7±0.8 years. According to the postoperative IICD/HPFL, 12 patients (80%) had successful outcome. The preoperative IICD had a mean of 37.6±1.5 mm, which was reduced post operative to a mean of 33.0±2.3 mm. The HPFL improved from preoperative mean 21±1.2 mm to postoperative mean 24.2±1.4 mm. The mean preoperative IICD/HPFL ratio was 1.8±0.2 which was reduced post operative to a mean of 1.37±0.2. The MRD1 improved from preoperative mean of 1±0.4 mm to 3.6±0.3 mm post operative. The main complication recorded was undercorrection which was observed in 3 patients (20%).

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Complications of fascia lata harvesting for ptosis surgery

Cited by 105 publications

References 8 publications

Long-term follow-up of ptosis correction using Mersilene mesh

Long-term follow-up of ptosis correction using Mersilene mesh

Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report

Outcome of Y to V Medial Canthoplasty With Medial Canthal Tendon Plication for the Correction of Blepharophimosis- Ptosis-Epicanthus Inversus Syndrome

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