title: Frontalis suspension with supramid suture: longevity results in very young patients with congenital ptosis.
abstract: OBJECTIVE
  To evaluate the duration of effect of frontalis suspension using Supramid suture (polyfilament, cable-type 3-0 suture) technique in very young children with congenital ptosis.
  
  
  METHODS
  The authors performed a retrospective review of 44 patients aged 4 years or less who underwent frontalis suspension using Supramid at the Bascom Palmer Eye Institute. Surgical success was defined as good eyelid height and position. Duration of the sling was defined as the time from initial surgery until additional surgery was performed or the date of last follow up. Kaplan-Meier survival analysis was performed with failure time measured as time from initial surgery until additional surgery was performed.
  
  
  RESULTS
  Kaplan-Meier survival analysis showed a success rate of 87.5% at 1 year, 78.2% at 2 years, 74.5% at 3 years, 58.2% at 4 years, and 53.7% at 5 years. Complications were noted in 10 cases (23%) and included damage to the Supramid sling secondary to trauma and granuloma formation.
  
  
  CONCLUSIONS
  Given the ready availability, ease of placement, and reliable cosmetic and functional results, Supramid suture is an excellent temporizing treatment option in cases of early amblyogenic congenital ptosis in children <4 years of age. Due to the inherent decline in effect over time and likely need for a secondary procedure at a later age, however, they do not recommend this as an alternative to other sling materials, such as autogenous fascia lata, in patients over 4 years of age.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Tanenbaum
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Johnson
authors.forename: Sara T
authors.initials: ST
authors.lastname: Wester
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital* / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009757:Nylons; D009801:Oculomotor Muscles / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D009757:Nylons