Frontalis suspension in congenital ptosis using a polyfilament, cable-type suture

Fifty-five frontalis sling procedures were performed with use of 4--0 polyfilament, cable-type ophthalmic suture (Supramid Extra) as the material for suspension. Recurrences numbered 16, recorded through a follow-up period of one to ten years. Trauma accounted for five recurrences. A pattern of gradual droop of the lid operated on became most obvious between six and ten years postoperatively and accounted for six of seven recurrences during this period. These findings suggest that this suture material is a poor alternative to fascia lata for permanent frontalis suspension in patients with congenital ptosis and should be used only in unusual circumstances, or when a temporary procedure is indicated.