title: Primary bilateral silicone frontalis suspension for good levator function ptosis in oculopharyngeal muscular dystrophy.
abstract: OBJECTIVE
  To evaluate outcomes of patients with oculopharyngeal muscular dystrophy (OPMD) with levator function (LF) ≥ 10mm who underwent primary bilateral silicone frontalis suspension.
  
  
  METHODS
  31 patients with OPMD satisfied the following inclusion criteria: LF ≥ 10 mm; no previous eyelid surgery; and pre-operative measurements, silcone frontalis suspension and post-operative measurements performed by a single individual. The following data were collected: age; gender; pre-operative margin reflex distance (MRD), palpebral fissure height (PF), and LF; post-operative MRD, PF and lagophthalmos; follow-up; and complications.
  
  
  RESULTS
  Mean age at surgery was 61.5 ± 5.8 years. Pre-operative measurements for MRD, PF and LF were -0.05 ± 0.82 mm (OD), -0.13 ± 0.91 mm (OS); 5.2 ± 1.2 mm (OD), 5.2 ± 1.3 mm (OS); 11.6 ± 1.3 mm (OD), and 11.7 ± 1.3 mm (OS), respectively. Post-operative measurements for MRD and PF were 2.23 ± 0.97 mm (OD), 2.10 ± 1.09 mm (OS), 7.9 ± 1.4 mm (OD), and 7.7 ± 1.6 mm (OS), respectively (all p < 0.0001). The mean follow-up period was 22.8 ± 22.4 months. There was no sling (infection or extrusion) or ophthalmic (significant corneal compromise) complication after the surgery. Six patients (19%) underwent early (within 3 months) tightening of their slings for under correction. Three patients (10%) underwent late (> 39 months) tightening of their frontalis slings for recurrent ptosis after their initial surgery.
  
  
  CONCLUSIONS
  Primary bilateral silicone frontalis suspension for good LF ptosis secondary to OPMD appears to be an effective, safe treatment which gives symmetrical upper lid elevation. Early sling adjustment may be required to attain optimal eyelid height and late tightening for expectant loosening of the sling is safe and effective.
authors.affiliation: Department of Surgery, Division of Ophthalmology, University of New Mexico School of Medicine, Albuquerque, New Mexico USA. richard-allen@uiowa.edu
authors.forename: Richard C
authors.initials: RC
authors.lastname: Allen
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Zimmerman
authors.forename: Emily A
authors.initials: EA
authors.lastname: Watterberg
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Morrison
authors.forename: Keith D
authors.initials: KD
authors.lastname: Carter
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000503:physiopathology / Q000601:surgery*; D005143:Eyelids / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D039141:Muscular Dystrophy, Oculopharyngeal / Q000601:surgery*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D012826:Silicone Elastomers; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D012826:Silicone Elastomers