Frontalis suspension using expanded polytetrafluoroethylene: results of different surgical designs.
OBJECTIVE
Several surgical designs and materials have been proposed for frontalis suspension for treating congenital ptosis and ptosis with poor levator muscle function. This study evaluated the surgical results of frontalis suspension using expanded polytetrafluoroethylene (ePTFE) with two different surgical designs (open-type and closed-type).


METHODS
We reviewed the medical records of 96 patients (68 children and 28 adults) who underwent frontalis suspension surgery using ePTFE. Postoperative eyelid position, ptosis recurrence, and complications were recorded.


RESULTS
Twenty-eight out of 68 children and all 28 adults underwent closed-type frontalis suspension surgery, and 40 children underwent open-type surgery. The recurrence rate was 20% (8 of 40 eyelids) for children with closed-type surgery, and 2% (1 of 50 eyelids) for those with open-type surgery. There was a statistically significant difference in the recurrence rate between the two surgical methods in children (p = 0.011). The recurrence rate was 5% (2 of 40 eyelids) in adults who underwent the closed-type method. The recurrence rate after closed-type surgery was significantly different between the child and adult groups (p = 0.04).


CONCLUSIONS
Open-type frontalis suspension surgery using ePTFE is preferable to closed-type surgery for children with upper eyelid ptosis. Closed-type surgery provides more favorable results in adults than in children.
Wei
Yi-Hsuan
YH
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Liao
Shu-Lang
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies
D011138:Polytetrafluoroethylene