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Two different techniques for frontalis suspension using Gore-Tex to treat severe congenital ptosis

  • Oculoplastics and Orbit
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Abstract

Purpose

Severe congenital ptosis is commonly associated with poor levator function. This study compares the functional and cosmetic outcomes of open versus closed frontalis sling using Gore-Tex in the treatment of such conditions.

Methods

Randomized interventional comparative case series of 20 eyes of 13 patients with severe congenital ptosis with levator excursion < 4 mm. Patients were treated by frontalis suspension using Gore-Tex string sutures either through a skin crease incision (group 1) or supraciliary incisions (group II).

Results

Mean age was 5.10 ± 3.10 years in group I and 7.30 ± 4.47 years in group II. Ptosis was unilateral in six patients and bilateral in seven patients. Following surgery, there was a statistically significant improvement in the palpebral fissure width (PFW) and marginal reflex distance (MRD) in both groups (p value 0.001) with better functional outcome in group II (closed approach). The cosmetic results were better in group I (open approach). The mean operative time in group II was 18.1 ± 2.4 min, which was significantly shorter than group I (30.2 ± 3.1 min). No recurrence or grave complications were encountered during follow-up.

Conclusion

Gore-Tex is a useful sling material for correction of severe congenital ptosis due to poor frontalis action. Open transcrease approach is recommended in absence of lid crease whereas closed approach is better used in cases with preserved crease due to its superior functional outcome

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Authors and Affiliations

  1. Ophthalmology department, Faculty of Medicine, Menoufia University, Shebin El Kom, Menoufia, Egypt

    Adel Galal Zaky, Sameh Saad Mandour, Marwa Aly Zaky & Asmaa Mohamed Ebrahem

Authors
  1. Adel Galal Zaky
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  2. Sameh Saad Mandour
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  3. Marwa Aly Zaky
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  4. Asmaa Mohamed Ebrahem
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Corresponding author

Correspondence to Adel Galal Zaky.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Cite this article

Zaky, A.G., Mandour, S.S., Zaky, M.A. et al. Two different techniques for frontalis suspension using Gore-Tex to treat severe congenital ptosis. Graefes Arch Clin Exp Ophthalmol 255, 831–835 (2017). https://doi.org/10.1007/s00417-017-3611-3

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  • DOI: https://doi.org/10.1007/s00417-017-3611-3

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