Related Experiment Video
Updated: Jun 24, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report
K K L Chong1, D S P Fan, C H Y Lai
1Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong, PRC.
Insights
Mersilene mesh frontalis sling (MMFS) surgery for severe congenital ptosis in infants is effective long-term. This study shows a low recurrence rate and no serious complications after 13 years.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Congenital ptosis is a common condition requiring surgical correction in infants.
- Early intervention is crucial for visual development and aesthetic outcomes.
- Autogenous fascia lata harvesting is a common method but requires older patients.
Purpose of the Study:
- To evaluate the long-term surgical, visual, refractive, and aesthetic results of the mersilene mesh frontalis sling (MMFS) procedure.
- To assess outcomes in infants under one year of age with severe unilateral congenital ptosis.
- To determine the efficacy and safety of MMFS in this pediatric population after 13 years.
Main Methods:
- A longitudinal follow-up study of 10 infants who underwent MMFS for severe unilateral congenital ptosis before one year of age.
- Data collected through structured ocular examinations, external photographs, and questionnaire-based interviews.
- Mean follow-up duration was 13 years.
Main Results:
- One patient (10%) experienced recurrent ptosis postoperatively.
- All patients maintained visual acuity within two Snellen lines between eyes.
- High patient satisfaction reported for lid position (83.3), cosmesis (77.0), and function (89.4).
- No cases of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy were observed.
Conclusions:
- MMFS demonstrates a low recurrence rate (10%) and a favorable safety profile with no serious complications after 13 years.
- The procedure is effective and feasible for infants under one year old with severe congenital ptosis.
- MMFS offers a viable alternative to delaying surgery for autogenous fascia lata grafting in infants requiring early correction.
Purpose:
To assess surgical, visual, refractive, and aesthetic outcomes 13 years after mersilene mesh frontalis sling (MMFS) operation for severe unilateral congenital ptosis performed in 10 infants before 1 year of age.
Methods:
Longitudinal follow-up of an interventional case series by structured ocular examinations, external photographs, and questionnaire-based interviews.
Results:
Mean age at surgery was 6.9+/-2.7 months. After a mean follow-up of 13.0+/-0.6 years, one patient (10%) had recurrent ptosis with the upper lid 2 mm below the superior limbus at 3 months postoperatively. Best-corrected visual acuities were within two Snellen lines between the two eyes in all patients. Astigmatic errors were 1.20+/-1.00 D and 1.10+/-1.70 D between operated and unoperated eyes. Four patients had 2 mm lid lag on down-gaze and one of them had 2 mm lagophthalmos. Mean satisfaction scores (scale of 1 to 100) for lid position, cosmesis, function, and to the procedure were 83.3+/-11.8, 77.0+/-22.9, 89.4+/-5.5, and 86.8+/-6.3, respectively. No case of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy was noted.
Conclusions:
In view of the low recurrence rate (10%) and absence of serious complication or need for revision after 13 years, the use of MMFS seems effective and feasible in infants less than 1 year old. Achieving compatible long-term stability, satisfactory aesthetic, and visual outcomes, MMFS may offer an alternative to delaying operations for autogenous fascia lata harvesting in infants requiring early ptosis correction.
