Frontalis Suspension Using Silicone Rod

ABSTRACT

PURPOSE: To evaluate the surgical results and complications in patients with blepharoptosis who underwent frontalis suspension using a silicone rod. METHODS: A total of 31 lids of 23 patients with blepharoptosis and poor levator function underwent a pentagon-shaped loop silicone sling surgery in which six skin incisions were made. Eighteen patients had congenital ptosis, two blepharophimosis-ptosis syndrome, two blepharoptosis with superior rectus muscle weakness, and one third nerve palsy. RESULTS: With a mean age of 14 years and a mean follow-up of 16 months, good-to-excellent lid height was achieved in 27 lids (87%) of 20 patients and poor results with undercorrection in 4 lids (13%) of 3 patients. Three of the 4 lids with poor results had reoperation and satisfactory results were achieved. Transient exposure keratitis occurred postoperatively in 7 lids (23%) and persistent exposure keratitis in 2 lids (6%). During the follow-up period, extrusion of the sling and infection did not occur; ptosis recurred in 4 lids (13%). CONCLUSIONS: Silicone rod can be adjusted easily after frontalis suspension, but it needs to pay close attention because the string can be broken during the operation or follow-up period. It is considered that additional follow-ups for a long-term recurrence rate of ptosis are necessary and sufficient explanation to the patients and family and their understanding are need.