Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report.
OBJECTIVE
To assess surgical, visual, refractive, and aesthetic outcomes 13 years after mersilene mesh frontalis sling (MMFS) operation for severe unilateral congenital ptosis performed in 10 infants before 1 year of age.


METHODS
Longitudinal follow-up of an interventional case series by structured ocular examinations, external photographs, and questionnaire-based interviews.


RESULTS
Mean age at surgery was 6.9+/-2.7 months. After a mean follow-up of 13.0+/-0.6 years, one patient (10%) had recurrent ptosis with the upper lid 2 mm below the superior limbus at 3 months postoperatively. Best-corrected visual acuities were within two Snellen lines between the two eyes in all patients. Astigmatic errors were 1.20+/-1.00 D and 1.10+/-1.70 D between operated and unoperated eyes. Four patients had 2 mm lid lag on down-gaze and one of them had 2 mm lagophthalmos. Mean satisfaction scores (scale of 1 to 100) for lid position, cosmesis, function, and to the procedure were 83.3+/-11.8, 77.0+/-22.9, 89.4+/-5.5, and 86.8+/-6.3, respectively. No case of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy was noted.


CONCLUSIONS
In view of the low recurrence rate (10%) and absence of serious complication or need for revision after 13 years, the use of MMFS seems effective and feasible in infants less than 1 year old. Achieving compatible long-term stability, satisfactory aesthetic, and visual outcomes, MMFS may offer an alternative to delaying operations for autogenous fascia lata harvesting in infants requiring early ptosis correction.
Chong
K K L
KK
Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong, PRC.
Fan
D S P
DS
Lai
C H Y
CH
Rao
S K
SK
Lam
P T H
PT
Lam
D S C
DS
D001763:Blepharoptosis / Q000151:congenital* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D011093:Polyethylene Terephthalates; D012029:Refraction, Ocular / Q000502:physiology; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D014792:Visual Acuity
D011093:Polyethylene Terephthalates; C025539:Lavsan