Related Experiment Video
Updated: May 2, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Frontalis suspension with supramid suture: longevity results in very young patients with congenital ptosis
Rebecca E Tanenbaum1, Wei Shi, Thomas E Johnson
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Insights
Frontalis suspension using Supramid suture in young children with congenital ptosis offers good initial results but has a declining effect over time. This technique is a viable temporizing option for children under 4, but not a long-term solution.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital ptosis is a common condition in young children.
- Frontalis suspension is a surgical technique used to correct ptosis.
- Supramid suture is a type of synthetic material used for slings.
Purpose of the Study:
- To evaluate the duration of effect of frontalis suspension using Supramid suture in children under 4 years old with congenital ptosis.
Main Methods:
- Retrospective review of 44 patients (≤4 years old) who underwent frontalis suspension with Supramid.
- Surgical success defined by eyelid height and position.
- Kaplan-Meier survival analysis to determine duration of sling effect.
Main Results:
- Success rates at 1, 2, 3, 4, and 5 years were 87.5%, 78.2%, 74.5%, 58.2%, and 53.7% respectively.
- Complications occurred in 23% of cases, including sling damage and granuloma formation.
Conclusions:
- Supramid suture is an effective temporizing treatment for congenital ptosis in children under 4 due to its availability and ease of use.
- The declining effect over time suggests it is not a substitute for materials like fascia lata in older children.
Purpose:
To evaluate the duration of effect of frontalis suspension using Supramid suture (polyfilament, cable-type 3-0 suture) technique in very young children with congenital ptosis.
Methods:
The authors performed a retrospective review of 44 patients aged 4 years or less who underwent frontalis suspension using Supramid at the Bascom Palmer Eye Institute. Surgical success was defined as good eyelid height and position. Duration of the sling was defined as the time from initial surgery until additional surgery was performed or the date of last follow up. Kaplan-Meier survival analysis was performed with failure time measured as time from initial surgery until additional surgery was performed.
Results:
Kaplan-Meier survival analysis showed a success rate of 87.5% at 1 year, 78.2% at 2 years, 74.5% at 3 years, 58.2% at 4 years, and 53.7% at 5 years. Complications were noted in 10 cases (23%) and included damage to the Supramid sling secondary to trauma and granuloma formation.
Conclusions:
Given the ready availability, ease of placement, and reliable cosmetic and functional results, Supramid suture is an excellent temporizing treatment option in cases of early amblyogenic congenital ptosis in children <4 years of age. Due to the inherent decline in effect over time and likely need for a secondary procedure at a later age, however, they do not recommend this as an alternative to other sling materials, such as autogenous fascia lata, in patients over 4 years of age.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...