title: Surgical treatment of severe congenital ptosis in patients younger than two years of age using preserved fascia lata.
abstract: OBJECTIVE
  To investigate the clinical outcome of a frontalis sling using preserved fascia lata in the treatment of vision-obscuring congenital ptosis in patients less than 2 years of age.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  The study was conducted in an institutional setting and included 82 patients with visual axis-obscuring congenital ptosis. All patients underwent frontalis sling surgery with preserved fascia lata between November 1994 and December 2008, and had a minimum follow-up of 6 months. Visual and surgical outcomes were assessed by reviewing clinical photographs and medical charts. Surgical outcomes were defined as good, fair, or poor, based on the postoperative lid level.
  
  
  RESULTS
  The mean age at surgery was 15.3 ± 4.8 months. After a mean follow-up of 54.8 ± 41.4 months, 64 patients (78.0%) showed good or fair surgical outcomes. Reoperation was performed in 16 of the patients with poor or fair results. Amblyopia was treated postoperatively in 75 of the 82 patients (91.5%) and had improved in 65 patients at the last follow-up. Postoperative entropion was identified in 5 cases, all of which were treated successfully. No other significant complications occurred.
  
  
  CONCLUSIONS
  For patients younger than 2 years of age, preserved fascia lata may be an appropriate substitute for autogenous fascia lata in frontalis sling surgery. Its long-term stability may enable a permanent effect in a certain proportion of patients, and may not require secondary surgery, which is common with synthetic materials.
authors.affiliation: Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Kyung In
authors.initials: KI
authors.lastname: Woo
authors.affiliation: Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea. Electronic address: ydkimoph@skku.edu.
authors.forename: Yoon-Duck
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Yong-Hwan
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000550:Amblyopia / Q000503:physiopathology / Q000601:surgery; D001763:Blepharoptosis / Q000151:congenital / Q000601:surgery*; D002675:Child, Preschool; D005206:Fascia Lata / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D014021:Tissue Preservation; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology