Five-Year Follow-Up of a 30-Month Trial of Stability of Silicone Band Frontalis Suspension for the Treatment of Severe Unilateral Upper Eyelid Ptosis in Infants. (3rd May 2016)

• Record Type: Journal Article
• Authors: Nucci, Paolo; Lembo, Andrea; Santangelo, Elisabetta; Fogagnolo, Paolo; Serafino, Massimiliano
• Is Part Of: Seminars in ophthalmology. Volume 31:Number 3(2016)
• Page Start: 215
• Page End: 218
• Publication Date: 2016-05-03
• Subjects: Blepharoptosis -- congenital ptosis -- frontalis suspension -- marginal reflex distance (MRD) -- silicone band; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Eye -- Surgery -- Periodicals; 617.7005
• DOI: 10.3109/08820538.2014.936618
• Languages: English
• ISSNs: 0882-0538

Abstract

Abstract: Purpose : To evaluate the five-year stability of frontalis suspension of the upper eyelid with a silicone band for the treatment of severe congenital ptosis in infants. Methods : Chart review of pediatric patients with a follow-up of five years after unilateral frontalis suspension with silicone band was reviewed. Margin-reflex distance (MRD) and corneal staining were measured at different follow-up visits. Data were analyzed by analysis of variance and t test for paired data. Results : Twenty pediatric patients were included in this retrospective study. MRD was severely reduced before surgery in all cases: it ranged from −1 mm to −4 mm (−2.4 ± 0.8 mm). After surgery, MRD increased to 2.9 ± 0.3 mm, and then progressively decreased by 0.6 mm within the first three months ( p < 0.001); a further reduction of 0.2 mm, occurring between three and 12 months after surgery, was not statistically significant ( p < 0.001). Between the 12-month and the five-year follow-up visits (one visit every six months), no changes in MRD were found for any patient. After the five-years visit, no substantial changes were recorded in 18 patients (90%); in two patients, a second surgery to improve the deterioration was necessary. Corneal staining, which was present in five patients (25%) during the first two postoperative weeks, disappeared over five years of follow-up. Conclusions : During the five-year follow-up of this retrospective study, the frontalis suspension with a silicone band proved to be a stable procedure. After 30 months from the first observation, MRD values were stable, except for two patients that underwent a second surgery to stabilize the worsening ptosis.