[A new biomaterial in surgery of ptosis with frontalis suspension: wide pore PTFE]

In brow suspension, there is agreement that fresh tissue (autogenous fascia lata or temporalis fascia) provides the best results in terms of low complications and duration of the effect. Yet, the morbidity of fresh tissue harvesting is not negligible. Many alternative materials have disadvantages in terms of duration of the procedure and side effects.

We have used a new material: wide porous expanded polytetrafluoroethylene (eP.T.F.E.). This material is an inert vitreous teflon alloplast with a high biocompatibility. It is close to Gore-Tex, but differs from it by a higher porosity (over 90%) and wider diameter of its pores (over 50 mus). We performed a series of 60 brow suspension from February 1992 to March 1994, using this new material.

We did not encounter any significant complications due to the material and in circumstance, we did not deplore any migration, infection or extrusion of the ePTFE. The biocompatibility seems to be increased, as it has been demonstrated by light and electron microscopy of the implanted material who revealed that fibrovascular ingrowth was significantly achieve two months after surgery.

The first results of this series are very encouraging. They can favourably be compared with the results of other series using different types of materials available in brow suspension. Though our longest follow-up is 30 months, further study is necessary to evaluate the long term results and eventual long term side effects of ePTFE, which avoid harvesting fresh tissues, thus reducing the brow suspension procedure's morbidity.