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The use of Prolene as a temporary suspensory material for brow suspension in young children
R M Manners1, A G Tyers, R J Morris
1Eye Unit, Southhampton General Hospital, UK.
Insights
Severe congenital ptosis in children can cause amblyopia. Prolene suture brow suspension offers a suitable temporary solution for very young children when autogenous fascia is unavailable.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital ptosis in children can lead to amblyopia if the eyelid obstructs the visual axis.
- Severe cases necessitate prompt surgical intervention, often requiring brow suspension due to poor levator muscle function.
Purpose of the Study:
- To evaluate the efficacy of 4/0 Prolene suture for temporary brow suspension in young children with congenital ptosis.
Main Methods:
- A review of 9 pediatric patients (age 4 years or younger) who underwent congenital ptosis repair.
- Brow suspension was performed using 4/0 Prolene (monofilament polypropylene) suture as a temporary material.
Main Results:
- All 9 patients achieved satisfactory outcomes, with the upper eyelid remaining clear of the visual axis.
- The mean follow-up period was 18.7 months (range 8-29 months).
Conclusions:
- Prolene suture serves as a suitable and readily available temporary material for brow suspension in very young children with congenital ptosis.
- This technique effectively maintains eyelid position, preventing visual axis obstruction.
Abstract:
Children with severe, unilateral congenital ptosis are at risk of developing amblyopia if the lid obscures the visual axis. In this situation, urgent repair of the ptosis is indicated. These patients generally have very poor function of the levator palpebrae superioris muscle and a brow suspension is required. The suspensory material which gives the best long-term results is autogenous fascia lata. In young children, however, there is insufficient autogenous fascia available. We reviewed 9 patients aged 4 years or less who had undergone surgery for congenital ptosis. In each case a brow suspension was performed using 4/0 Prolene (monofilament polypropylene) suture as a temporary suspensory material. All patients achieved a satisfactory result with the upper lid remaining clear of the visual axis during a mean follow-up period of 18.7 months (range 8-29 months). We suggest that Prolene suture is a readily available material which is suitable as a temporary suspensory material for brow suspension in very young children.