Abstract
Purpose: :
To assess the functional results and complications associated with the use of ePTFE (ptose–up) in frontalis suspension to correct ptosis secondary to poor levator function.
Methods: :
The study is a retrospective medical record analysis of patients undergoing frontalis suspension in which ePTFE was implanted by one surgeon (EB) at the Detroit Medical Center between 4/6/2001 and 9//2005. Twenty nine of these were primary procedures; eight were secondary or tertiary procedures. All of the patients included in the study had severe ptosis with poor levator function (0–5 mm). A total of 27 patients were included in the study (24 children and 3 adults), with an age range of 2 years to 72 years. The procedure was performed on a total of thirty seven eyelids (19 unilateral cases and 9 bilateral cases). Pre– and post–operative measurements including MRD1, levator function, lid height with brow effort and presence/magnitude of lagophthalmos were recorded and utilized to draw conclusions regarding efficacy of the material. Additionally, outcome was judged on clinical examination regarding eyelid height and symmetry as well as clearance of the visual axis.
Results: :
Twenty–seven total eyelids (73%) were deemed to have a good outcome by the predetermined criteria. Three patients (8.1%) developed a post–operative infection requiring excision of a granuloma or lesion. Two patients underwent removal or partial removal of the sling secondary to infection resulting in implant extrusion. Nine eyelids (24.3%) were found to have mild, transient lagophthalmos; all of these were inconsequential. Eight (21.6%) lids experienced recurrent ptosis following ePTFE frontalis sling. Average time to recurrence was 13.59 months, with a range of 1 week to 42 months.
Conclusions: :
ePTFE provides good functional results when used in frontalis suspension. Though not a prospective, head–to–head comparison of all materials, our results show rates of success and infection comparable to banked fascia lata and superior to other synthetic products.
Keywords: eyelid • anatomy