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Cajal Patel, Chrysavgi Adamopoulou, Leemor Rotberg; Frontalis Suspension for Congenital Ptosis: Evaluation of Suture Material in Pediatric Patients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4741.
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Congenital ptosis is caused by myogenic dysgenesis, which can cause deprivation or refractive amblyopia in young patients. To compensate, they often adopt an anomalous head position, which can limit mobility and cause neck strain. For patients with poor levator function, the ptosis is typically managed by frontalis sling to correct the head position and manage or prevent amblyopia. Several studies have evaluated the outcomes of this procedure. However, patients with ptosis of any etiology as well as of all ages were included in those studies. We assessed the surgical outcomes of pediatric patients undergoing frontalis sling strictly for congenital ptosis without a previous history of eyelid surgery. We hypothesized that recurrence rates would vary depending on the material used.
The charts of 39 patients with congenital ptosis who underwent frontalis sling were retrospectively reviewed. All surgeries were performed by the same surgeon and the same surgical technique was used in all patients. Forty-nine (n=49) eyes were included in the study. Patients with previous lid surgery or ptosis of an etiology other than congenital were excluded. The mean age of patients was 9.5 months. Data collected at the time of surgery included age, visual acuity, refractive error, margin to light reflex distance(MRD1), levator function, suture material, as well as the presence of amblyopia, strabismus or chin up position. MRD 1 was also recorded in all post-operative visits as well as the time to recurrence. The average follow-up was 18.1 months for those who did not develop recurrence. Suture material used included ptose-up, (N=17),supramid (N=28) and silicone rods (N=4) .
No statistical significance was found in the rate of recurrence between the two materials.
Evaluation of a larger sample size may help determine if suture material has any bearing on surgical outcome, recurrence and complication rate, which may help guide surgical practice in the management of congenital ptosis.
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