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Anu S. Patel, Metasebia Munie, Elena Gianfermi, John Roarty; Comparison of Failure Rates and Granuloma Formation Rates in Pediatric Frontalis Suspensions. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1574.
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The purpose of this study is to evaluate and compare the failure rates and rates of granuloma formation between Supramid and Ptose-up suspensory materials in pediatric patients after a frontalis suspension procedure for the repair of congenital ptosis.
A retrospective chart review was performed from pediatric patients diagnosed with congenital ptosis from 2000 to the present at the Children’s Hospital of Michigan. Each patient was treated with frontalis suspension procedures using Ptose-up or Supramid materials over a 10 year period. Indications for surgery included ptosis obscuring the visual axis, ptosis with anomalous head position, or induced astigmatic amblyopia. Criteria for failure included margin-reflex distance (MRD) less than 2 mm at 6 months follow-up and the need for re-operation within 6 months of surgery.
53 patients underwent 72 frontalis suspensions by 6 surgeons. 25 patients were excluded based on follow-up less than 6 months. Average follow-up for patients included in the study was 20.16 months. 79% were primary procedures, 19% were second operations, and 2% were third operations. 25 patients underwent procedures involving Ptose-up and 22 patients had Supramid. Pre-operative MRD was similar in both groups (<0.5 mm). Patients with Supramid frontalis suspensions were significantly younger than those who underwent suspensions with Ptose-up (1.67 yrs vs 6.54 yrs, p<.0001). 10 of 25 patients (40%) in the Ptose-up group were failures compared to 9 of 22 patients (41%) in the Supramid cohort (p=.949). Granuloma formation occurred in 7 of 25 patients (28%) in the Ptose-up cohort while 0 of 22 patients (0%) in the Supramid cohort developed granulomas.
There is no significant difference in failure rates among frontalis suspensions performed with either Supramid or Ptose-up suspensory materials. There is a significantly higher rate of granuloma formation in the Ptose-up group compared to the Supramid group.
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