Functional results and complications of Mersilene mesh use for frontalis suspension ptosis surgery

Mehta, Purnima

doi:10.1136/bjo.2002.009951

Cited by 70 publications

(50 citation statements)

References 27 publications

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“…The modified technique consisted of soaking the mesh with gentamicin solution before insertion, the ends of the Mersilene mesh were sutured together (rather than tied) and finally buried under frontalis muscle. We did not experience any of the soft tissue complications encountered in other studies 1,18,19 and still found our results with the Mersilene mesh very encouraging.…”

Section: Discussionsupporting

confidence: 52%

Paediatric blepharoptosis: a 10-year review

Berry-Brincat

Willshaw

2008

Eye

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Purpose To examine the characteristics of blepharoptosis and the success of surgical intervention in a large group of children presenting to a specialist at paediatric ophthalmology center. Methods Ten-year retrospective case notes review of patients presenting to the Birmingham Children's Hospital for blepharoptosis surgery. Resultant database was interrogated for aetiology of ptosis; severity; surgical correction; outcome; complications and need for reoperation. Results One hundred and fifty five children (186 eyes) underwent blepharoptosis surgery. Hundred and ten patients (71%) were treated with a levator resection procedure, 28 (18%) underwent a brow suspension using Mersilene mesh, 15 (10%) with Fasanella Servat procedure and 2 (1%) with La Mange procedure. The mean post-operative follow-up was 30.82 months with 84 children completing a minimum of 12 months follow-up. Overall, 70.97% lids were successfully corrected with a single operation. In 9.14% lids, the results were fair but no further surgery was carried out. Reoperation was required in 19.89% of lids with the mean time to second surgery being 32.69 months. Amblyopia was found in 26.45% (41 children); in 3 patients, their amblyopia became manifest after the ptosis surgery. A concomitant squint was present in 14.19%, and 18.70% had a significant refractive error requiring spectacles prescription, with anisometropia present in more than 72% of these patients. Conclusions Early referral to an ophthalmologist is necessary even though surgical correction may be delayed. Children with congenital ptosis need to be monitored for amblyopia both pre-and post-operatively, as the incidence of strabismus and refractive errors is much higher than the general population and these may develop even after ptosis surgery.

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Section: Discussionsupporting

confidence: 52%

Paediatric blepharoptosis: a 10-year review

Berry-Brincat

Willshaw

2008

Eye

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“…[1][2][3][4][5][6][7][8][9][10][11][12]17,18 We measured the MRD with the eyelid(s) 'at rest'. This provides an objective, albeit conservative, outcome measure.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] In children, such materials are often used as temporary measures until autogenous fascia lata frontalis suspension can be performed. Prolene has been shown to be an adequate temporary suspensor material for frontalis suspension in very young children, 14 but other studies of prolene in ptosis surgery have reported mixed results.…”

Section: Introductionmentioning

confidence: 99%

Prolene frontalis suspension in paediatric ptosis

Chow

Deva

2011

Eye

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Aim The aim of this study was to assess the efficacy of frontalis suspension using 4-0 prolene sutures for paediatric ptosis with poor levator function. Patients and methods A retrospective chart review was performed on children who underwent 4-0 prolene frontalis suspension from 2000 to 2008 with a minimum of 6 months' follow-up. Functional success was defined when three criteria were met: (a) satisfactory lid height (defined as marginto-reflex distance Z3 mm with minimal frontalis muscle tone); (b) satisfactory lid symmetry (r2 mm asymmetry in margin-toreflex distance); and (c) satisfactory cosmesis. Recurrence was defined by a drop in lid height of Z3 mm from the initial post-operative level. Results A total of 23 patients (30 eyelids) were included. The mean follow-up duration was 28.7 months (range 6.3 to 100 months). The functional success rate was 74% (17/23 patients). Ptosis recurred in 22% (5/23) of patients. Only one patient (4%) developed a complication: a case of minor wound infection. Conclusions In paediatric ptosis with poor levator function, prolene frontalis suspension has good efficacy and an excellent safety profile. The results of prolene frontalis suspension are comparable to those of other non-autogenous materials.

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“…Moreover, it serves as a permanent scaffold for fibrovascular ingrowth promoting tissue incorporation. 4,[8][9][10][11][12][13][14][15] Banked fascia lata or sclera and synthetic materials like monofilament nylon, polyfilament cable-type nylon suture (Supramid Extra), braided polyester, expanded polytetrafluroethylene (Gore-tex), polypropylene, and silicone rod 4,5 have been used as alternative sling materials, with a higher rate of ptosis recurrence and soft tissue complications in the long run compared with AFL.…”

Section: Introductionmentioning

confidence: 99%

Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report

Chong

Fan

Lai

et al. 2009

Eye

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Purpose To assess surgical, visual, refractive, and aesthetic outcomes 13 years after mersilene mesh frontalis sling (MMFS) operation for severe unilateral congenital ptosis performed in 10 infants before 1 year of age. Methods Longitudinal follow-up of an interventional case series by structured ocular examinations, external photographs, and questionnaire-based interviews.Results Mean age at surgery was 6.9±2.7 months. After a mean follow-up of 13.0±0.6 years, one patient (10%) had recurrent ptosis with the upper lid 2 mm below the superior limbus at 3 months postoperatively. Best-corrected visual acuities were within two Snellen lines between the two eyes in all patients. Astigmatic errors were 1.20±1.00 D and 1.10±1.70 D between operated and unoperated eyes. Four patients had 2 mm lid lag on down-gaze and one of them had 2 mm lagophthalmos. Mean satisfaction scores (scale of 1 to 100) for lid position, cosmesis, function, and to the procedure were 83.3 ± 11.8, 77.0±22.9, 89.4±5.5, and 86.8±6.3, respectively. No case of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy was noted. Conclusions In view of the low recurrence rate (10%) and absence of serious complication or need for revision after 13 years, the use of MMFS seems effective and feasible in infants less than 1 year old. Achieving compatible long-term stability, satisfactory aesthetic, and visual outcomes, MMFS may offer an alternative to delaying operations for autogenous fascia lata harvesting in infants requiring early ptosis correction.

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Functional results and complications of Mersilene mesh use for frontalis suspension ptosis surgery

Cited by 70 publications

References 27 publications

Paediatric blepharoptosis: a 10-year review

Paediatric blepharoptosis: a 10-year review

Prolene frontalis suspension in paediatric ptosis

Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report

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