Gore-Tex soft-tissue patch frontalis suspension technique in congenital ptosis and in blepharophimosis-ptosis...

The frontalis suspension technique is the surgical method of choice in ptosis patients with a levator function of 2 mm or less. This type of ptosis is found unilaterally or bilaterally in isolated congenital ptosis and mostly bilaterally in blepharophimosis-ptosis patients. The frontalis suspension technique is frequently used in children being operated on because of congenital ptosis, where the excision of the fasciae latae can be avoided so as not to risk scarring the donor area. Since the new heterologous material polytetrafluoroethylene (Gore-Tex soft-tissue patch) has been available (1986), it has been used on our ptosis patients with minimal levator function instead of the formerly much used fasciae latae. Thirty-seven frontalis suspension procedures have been performed in 26 patients, of whom 6 were children who suffered from bilateral blepharophimosis-ptosis syndrome. All ptosis procedures were performed as Fox pentagons, and in the combined cases, the medial canthoplasty was carried out as a bilateral one-stage procedure. The postoperative healing was free of complications. Three years postoperatively one patient did exhibit rejection of one of the two implanted Gore-Tex slings. In all other patients, the functional and cosmetic results were satisfying, and high biocompatibility of the Gore-Tex soft-tissue patch material could be shown.