Long-term follow-up of ptosis correction using Mersilene mesh

Sharma, Tushar; Willshaw, H E

doi:10.1038/sj.eye.6700498

Cited by 11 publications

(13 citation statements)

References 11 publications

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“…8 However, after modifying the technique, there were no further complications. 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.…”

Section: Discussionmentioning

confidence: 93%

“…7 The severity of the ptosis and the associated compensatory head posture and occlusion of the visual axis dictated the timing of the surgery. 8 …”

Section: Patientsmentioning

confidence: 99%

“…Mersilene mesh was the suspension material of choice in all our cases of brow suspension and was inserted as a Fox pentagon. 8 La Mange procedure 10 was used in two cases of Marcus Gunn jaw winking phenomenon. A two-staged technique was performed with levator transposition initially followed by levator resection at a later date.…”

Section: Surgical Techniquementioning

confidence: 99%

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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: Discussionmentioning

confidence: 93%

“…7 The severity of the ptosis and the associated compensatory head posture and occlusion of the visual axis dictated the timing of the surgery. 8 …”

Section: Patientsmentioning

confidence: 99%

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Paediatric blepharoptosis: a 10-year review

Berry-Brincat

Willshaw

2008

Eye

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“…Banked FL has not been a good substitute because of its high recurrence rate, for example 51.4% at a mean follow-up of 41 months reported in one study. 5 Synthetic materials, such as prolene, 4 monofilament, 5 silicone and mersilene 6,7 are available as alternatives. Most reports involving synthetic materials tend to be small series with limited follow-up.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of autogenous palmaris longus frontalis sling in children with congenital ptosis

Wong

Fan

et al. 2004

Eye

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Purpose To investigate the long-term outcome of using autogenous palmaris longus tendon (PLT) sling for correcting congenital ptosis in children. Methods This is an observational case series involving 15 eyelids of 14 consecutive children with congenital ptosis who underwent frontalis suspension surgery using PLT in a university teaching hospital. Results One child had bilateral ptosis and the other children had unilateral ptosis. The age of patients at the time of surgery ranged from 2 to 7 years, with an average of 4.7 years. At a mean follow-up of 92 months (range, 80-104 months), all eyelids were successfully corrected with good lid height. No recurrence or other postoperative complications were encountered except one patient who developed a small skin fold over the PLT harvest site. Conclusion Long-term lid position is remarkably stable after surgical correction using PLT. PLT sling appears to be a safe and effective treatment for children with congenital ptosis requiring frontalis sling operation. It could be a good alternative to autogenous fascia lata, and further studies, to compare these two sling materials seem warranted.

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“…It is inexpensive, easy to handle, and can be sterilized. 7 Tensile strength reduces o4% after the first year of implantation and the sling is unlikely to lengthen with time causing ptosis recurrence. Moreover, it serves as a permanent scaffold for fibrovascular ingrowth promoting tissue incorporation.…”

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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Long-term follow-up of ptosis correction using Mersilene mesh

Cited by 11 publications

References 11 publications

Paediatric blepharoptosis: a 10-year review

Paediatric blepharoptosis: a 10-year review

Long-term results of autogenous palmaris longus frontalis sling in children with congenital ptosis

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

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