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Surgical Treatment of Severe Ptosis by Modified Brow Suspension Technique
Ali Adawal Ali1, Abdulhameed Abdul Majeed Hassan1, Marwan Salah Salman2
1Department of Surgery, College of Medicine, Kirkuk University, Kirkuk, Iraq.
Insights
The frontalis sling operation using double-threaded prolene effectively corrects severe blepharoptosis (droopy eyelid) with favorable long-term results. This surgical technique is a viable option for patients with minimal levator muscle function.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Ptosis Correction
Background:
- Blepharoptosis, or droopy eyelid, affects all age groups and may require surgical correction for functional and cosmetic reasons.
- Urgent treatment for blepharoptosis in children under three is crucial to prevent amblyopia (lazy eye).
- Surgical approach for ptosis depends on its severity and the patient's levator muscle function.
Purpose of the Study:
- To evaluate the functional outcomes and complications of the frontalis sling operation.
- To assess the efficacy of double-threaded prolene as a suspensory material for severe ptosis correction.
- To analyze results in patients with minimal or absent levator muscle function.
Main Methods:
- A frontalis sling procedure using double-threaded prolene was performed on 72 eyelids in 59 patients with severe unilateral or bilateral ptosis.
- A cannula was utilized for introducing the prolene material during the surgery.
- Patients were monitored for an average of 21 months post-surgery to assess results and complications.
Main Results:
- The frontalis sling operation yielded favorable long-term functional and cosmetic results in the majority of patients.
- A recurrence of ptosis was observed in 5 eyelids, predominantly in patients younger than 5 years old.
- Minor complications included incomplete eyelid closure (2 lids), overcorrection (1 lid), and corneal exposure with keratitis (1 eye); however, infection and wound issues were absent.
Conclusions:
- The frontalis sling operation utilizing double-threaded prolene is an effective surgical method for correcting severe blepharoptosis.
- This technique demonstrates good long-term efficacy and acceptable complication rates for ptosis repair.
Background:
Blepharoptosis can occur at any age. Its surgical correction may be indicated for functional and cosmetic purposes. Blepharoptosis treatment in children <3 years old may be required on an urgent basis to prevent amblyopia. The type of surgery depends on the severity of ptosis. The purpose of the study is to assess the functional results and complications of frontalis sling operation using double-threaded prolene as a suspensory material to correct severe ptosis with minimal or no levator muscle function.
Methods:
In total, 72 lids of 59 patients (both male and female) having severe unilateral or bilateral ptosis were included. Frontalis sling with double-threaded prolene using cannula for introducing prolene was used to correct severe ptosis in these patients. Patients were followed up for an average of 21 (range: 12-24) months postoperatively for evaluating the functional and cosmetic results as well as possible complications.
Results:
Favourable long-term functional and cosmetic results were achieved in most patients. The overall recurrence rate of ptosis was in 5 lids, most of which were in <5-year-old patients. Other complications were incomplete closure in 2 lids, overcorrection in 1 lid, and corneal exposure and exposure keratitis in 1 eye. Infection, wound problems, and supratarsal sulcus obliteration were not observed in any case during the follow-up period.
Conclusions:
Frontalis sling operation using double-threaded prolene as a suspensory material is an effective technique to correct severe ptosis.
