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Published on: June 20, 2018
Early correction of severe unilateral infant ptosis with the Mersilene mesh sling
1Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
Insights
Frontalis suspension using Mersilene mesh effectively corrected severe congenital ptosis in infants, improving eyelid position and resolving head posture. This surgical technique shows promise for early intervention in young children.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital ptosis is a condition affecting eyelid position in infants.
- Early surgical intervention aims for functional and cosmetic improvements.
- Traditional methods like fascial harvesting may not be suitable for very young infants.
Purpose of the Study:
- To evaluate the efficacy of frontalis suspension using Mersilene mesh for severe unilateral congenital ptosis in infants under one year of age.
- To assess functional outcomes, cosmetic results, and complications associated with this surgical approach.
Main Methods:
- A consecutive series of ten infants with severe unilateral congenital ptosis underwent frontalis suspension using Mersilene mesh before 12 months of age.
- Surgical correction was performed with the goal of early functional and cosmetic improvement.
- Patients were followed for a mean of 40.3 months.
Main Results:
- All patients achieved normal or near-normal eyelid position post-surgery.
- Chin-up head posture was resolved in all cases.
- One patient experienced mild exposure keratitis, successfully managed with topical treatment.
Conclusions:
- Mersilene mesh sling suspension is a viable surgical option for managing congenital ptosis in infants too young for fascial harvesting.
- The technique demonstrated good potential for achieving early functional and cosmetic benefits.
- Further research with larger patient cohorts and longer follow-up is necessary to confirm long-term safety and efficacy.
Abstract:
Ten consecutive cases of severe unilateral congenital ptosis were surgically corrected before 1 year of age (range 3-11 months) in an attempt to achieve early functional and cosmetic improvement. In all cases, a frontalis suspension using Mersilene mesh was performed. With a mean follow-up of 40.3 months (range 33-54 months), all patients achieved normal or near normal eyelid position and all had their chin-up head posture resolved. One patient developed a mild exposure keratitis that was treated successfully with topical antibiotics and lubricants. Our findings suggest that the Mersilene mesh sling has good potential for ptosis management in infants who are too young for fascial harvesting. However, a larger series with a longer follow-up period is required before the eventual safety and efficacy of the Mersilene mesh sling can be properly ascertained.
