Treatment of Congenital Ptosis with Frontalis Suspension

Wagner, Rudolph S; Mauriello, Joseph A.; Nelson, Leonard B; Calhoun, Joseph H.; Flanagan, Joseph C.; Hårley, Robison D.

doi:10.1016/s0161-6420(84)34298-1

Cited by 143 publications

(80 citation statements)

References 5 publications

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“…[17] Synthetic materials are also used in frontal suspension, but the success and the complication rates are different in different studies. [17,18,19] Carter et al performed frontal suspension with silicon bands in a total of 61 eyes (17 of them congenital) and reported excellent and good results after a mean follow-up period of 22 months, with only 4 eyes requiring revision. Silicon band extrusion, however, was reported in 3 (5%) eyes.…”

Section: Typementioning

confidence: 99%

Study of the Outcome of Various Surgical Procedures for Simple Congenital Blepharoptosis

Kabra¹,

Khatri²

2015

jemds

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AIM & OBJECTIVE:The aim of the study is to evaluate the functional and cosmetic outcome and compare the complications of various ptosis surgeries done for simple congenital ptosis at a tertiary care hospital. METHODS: 46 patients with 52 eyelids having undergone ptosis surgery for congenital simple blepharoptosis were included in our study. Patients of all age groups and either sex which post-operatively completed a follow-up period at 1, 3, 6 months were included in the study and grouped under four groups-levator resection, silicon sling, Fascia Lata sling, Fasanella Servat surgery. The postoperative outcome and complications were noted in all cases. RESULTS: Out of 52 eyelids operated for blepharoptosis, 45 cases (86.54%) had good, 5 (9.62%) had fair and 2 (4.35%) had poor post-operative outcome. Though on applying the chi square test there was no significant difference observed in the cosmetic and functional outcome between all the groups but the maximum number of complications was noted in the silicon sling group. CONCLUSION: With the selection of the right surgery depending on amount of ptosis and levator muscle action we could achieve good cosmetic correction and minimal complications in most of our cases.

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Section: Typementioning

confidence: 99%

Study of the Outcome of Various Surgical Procedures for Simple Congenital Blepharoptosis

Kabra¹,

Khatri²

2015

jemds

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“…[4][5][6] Most synthetic materials do not have adequate tissue incorporation and the results are typically less satisfactory in the long term. 7 The synthetic macromesh material Mersilene was first reported by Downes and Collin 8 in 1989, as a suspending material in ptosis surgery. It has been used as a surgical material for many years and evidence suggests that it acts as a permanent scaffold for fibrovascular ingrowth and becomes well integrated into the surrounding tissue.…”

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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“…[1][2][3] At present, the gold standard of suspensory material is autologous fascia lata (AFL) owing to its superior stability and cosmetic results. [1][2][3][4][5][6] Not all children are suitable candidates, as the fascia lata is generally not well developed enough before 3 years of age. [1][2][3] Mersilene Mesh (MM: Ethicon, Somerville, NJ, USA) is a synthetic non-absorbable macro-mesh (polyester) widely used in general vascular and orthopaedic surgery.…”

Section: Introductionmentioning

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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Treatment of Congenital Ptosis with Frontalis Suspension

Cited by 143 publications

References 5 publications

Study of the Outcome of Various Surgical Procedures for Simple Congenital Blepharoptosis

Study of the Outcome of Various Surgical Procedures for Simple Congenital Blepharoptosis

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

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