title: [Surgical treatment of severe degree of ptosis of the upper eyelid using a Fronto-tarsal sling of biocompatible PVC].
abstract: OBJECTIVE
  ptosis is anomalous drop of the upper eyelid. Depending on the cause of the state and especially according to the results of clinical findings (dominated significance of elevation of the upper eyelid) we can be perform various surgical procedures. Operation under Fasanella-Servat is suitable for the easiest cases - function of the upper eye-lid levator muscle (levator) is at least 10 mm and a maximum of 2 mm ptosis. Aponeurosis advancement has good results in all types of involutional origin. Eyelid levator resection is performed when the levator function is better than 5 mm. Eye-lid sling to brow lift mechanism is designed for the toughest conditions, when the levator function is worse than 4 mm. The authors present the results of surgery for ptosis with biocompatible PVC tube fronto-tarsal sling.
  
  
  METHODS
  case-reports of 4 eyes in 3 adult patients were prospectively monitored. It was a one man and two women with different etiologies of ptosis. The principle of operation is suspension the upper eyelid to eyebrow-levators using PVC tubes in the subcutaneous tissue. Monitored parameters were: best corrected visual acuity, clinical finding of the front segment (with an emphasis on lagophthalmos in the postoperative period), eye-fissure height and levator function in millimeters (mm).
  
  
  RESULTS
  there was the most severe degree of ptosis in all cases. In terms of functional and cosmetic effect treatment were surgeries successful in all patients. One half of the cases (2 of 4 eyes) had transient postoperative lagophtalmos, which in one case was solved with moisture chamber. None of exposure keratopathy developed. In one case, it was after 9 months after the operation, we had to extract one implant due to extruzion of the tube.
  
  
  CONCLUSIONS
  The fronto-tarsal tubing with biocompatible PVC is effective and relatively safe technique in cases of severe degree of ptosis of the upper eyelid. The material appears to be well tolerated by the surrounding tissue.
authors.forename: H
authors.initials: H
authors.lastname: Hejsek
authors.forename: V
authors.initials: V
authors.lastname: Veliká
authors.forename: A
authors.initials: A
authors.lastname: Stepanov
authors.forename: P
authors.initials: P
authors.lastname: Rozsíval
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011143:Polyvinyl Chloride; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D014792:Visual Acuity
chemical_list: D001672:Biocompatible Materials; D011143:Polyvinyl Chloride