Management of Mersilene® mesh chronic eyelid complications: a systematic approach

Abstract

Background Mersilene mesh (polyester fibre) is commonly used in ptosis surgery for frontalis suspension as it is readily available and cheap. Management of extrusion can be challenging. We report three cases of extrusion where extremely thick mesh or extremely thin tissue may have contributed to the extrusion. Methods Retrospective case note study of three adult patients who developed chronic mesh extrusion. Results Extrusion and chronic infection occured 5-12 months after surgery. Despite systemic antibiotics, all three patients required surgical excision of mesh from the eyelid up to the brow, which was curative. Conclusion These cases illustrate the need for a systematic approach and the need in some cases to excise the mesh to prevent recurrent infection.

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

“…Removal of the mesh may result in ptosis, especially as a long length of mesh is dissected out both from the eyelid and between the eyelid and brow. 31 There is a trade-off between complications and effectiveness for non-autogenous frontalis suspension materials.…”

Nanostructural investigation of frontalis sling biomaterial surfaces

“…Most studies attempted to evaluate the functional success of a range of biomaterials in frontalis sling surgery. Fresh autogenous fascia lata to show lower blepharoptosis recurrence and a lower complication rate is considered the most suitable biomaterial for repairing the poor levator function (Wagner et al ., '84; Wilson and Johnson, '91; Zweep and Spauwen, '92; Wasserman et al ., 2001; Leibovitch et al ., 2003; Metha et al ., 2004a,b; Philandrianos et al ., 2010). The main advantage of an autogenous fascia lata is that it is a permanent living suture and produces long‐lasting repair of blepharoptosis (Crawford, '77; Gürdal et al ., 2003).…”

“…Among these sling biomaterials, the autogenous fascia lata (Fig. 1) is believed the best biomaterial for blepharoptosis surgery with comparably low rates of recurrent blepharoptosis and infections (Wagner et al ., '84; Zweep and Spauwen, '92; Wasserman et al ., 2001; Leibovitch et al ., 2003; Metha et al ., 2004a,b; Philandrianos et al ., 2010). On the other hand, they require a second operative site and additional surgery time.…”

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

“…28 Soft tissue complications including sling extrusion, wound granuloma, or infection occurred in 0-35% of cases. 29 We suspect that different sling preparation and surgical techniques may at least, in part, account for such wide range of outcomes. Subject with recurrent ptosis.…”