Anterior approach levator plication for congenital ptosis, absorpable versus non absorpable sutures

Abstract

Purpose: To compare the efficacy of two different suture types in levator plication for correction of congenital ptosis. Subjects and methods: Prospective comparative interventional randomized study involving 42 eyes of 42 patients aged more than 6 years with congenital ptosis and good levator action. The exclusion criteria were as follows: bilateral ptosis, history of previous surgery, fair or poor levator action, and associated other ocular diseases. Patients were randomized into group A, in which double-armed 5/0 polyester Ethibond were used, and group B, in which double-armed 5/0 Coated Vicryl® (polyglactin 910) suture material we used. Outcomes including eyelid height and stability of eyelid height over time were compared with follow-up data. The MRD was 4.05 ± 0.36 mm and 3.95 ± 0.34 after 1 week for both groups A and B, respectively. At the end of study follow up period (24 weeks), the MRD was 3.60 ± 0.42 mm in group A, and 2.52 ± 0.85 mm in group B. Conclusion: No difference in eyelid height between two groups in early postoperative period, but the postoperative eyelid height was more stable over time in the 5/0 polyester Ethibond group (group A) than in the 5/0 Coated Vicryl® (polyglactin 910) group (group B).

Outcomes of a novel algorithm for levator muscle plication surgery in congenital blepharoptosis

“…Our study revealed that the novel algorithm we created for levator muscle plication is effective with a high success rate (90%). Our results are consistent with recent studies that have reported surgical success with transcutaneous levator plication in congenital ptosis to range from 85–95% [ 2 , 3 , 12 ]. This new algorithm depends on the degree of ptosis and levator function, both of which are important factors that affect the results of ptosis surgery [ 8 , 13 ].…”

“…We didn’t report any cases of recurrence till the last follow-up visit. The use of non-absorbable (Ethibond) suture to plicate the levator muscle gives long standing results and prevents recurrence [ 2 ]. All patients in our study had a good postoperative aesthetic appearance.…”

“…Treatment is mainly surgical, and the choice of the appropriate surgical technique depends mainly on the degree of levator function. When the levator function is equal to or greater than 5 mm, levator muscle resection or plication is preferred [ 2 ]. The levator resection technique is considered the gold standard as it is a well-known procedure with predictable results.…”