One medial triangular Tutoplast sling as a frontalis suspension for adult myogenic blepharoptosis

Abstract

ABSTRACT.Purpose: The treatment of choice for medium to severe blepharoptosis with minimal or no levator function is frontalis suspension with a sling, using a rectangular or rhomboid sling placement technique. We describe the shortterm, follow-up results of frontalis suspension surgery for adult myogenic blepharoptosis using Tutoplast, a commercially available fascia lata allograft. Methods: We conducted a consecutive, interventional case study. All adult (>25 years of age) patients operated for non-traumatic myogenic ptosis during a 1-year period were included. All underwent frontalis suspension using one medial triangular Tutoplast sling. Success was judged according to lid position and complications. Results: Successful surgical results were judged by lid level, lid symmetry and lid contour. During a mean follow-up of 9 months, the success rate was 91% in all three criteria and 100% in at least two out of three. No major complications were observed. The most prevalent minor complication was the need for lubrication treatment in 26% of the operated patients. Conclusion: The use of Tutoplast for frontalis suspension in cases of adult myogenic ptosis is safe and has a high success rate in the early postoperative period. Further large-scale studies are necessary to ascertain the longterm results and the applicability of this material to other indications.

Long-term result of direct frontalis sling with fascia lata in congenital ptosis

“…When performing a frontalis sling operation, a surgeon must select both the surgical method and the sling material. There are several established surgical methods [5][6][7][8][9][10][11], but the open sky method [13] and the modified Crawford method [14] are currently 2 of the most popular choices for oculoplastic surgeons. Suspensory materials for the frontalis sling operation can be divided into 3 categories, namely, synthetic, autogenous fascia lata, and allograft fascia lata.…”

“…J Cosmet Med 2019;3(1):14-18 https://doi.org/10.25056/JCM.2019.3. 1.14 pISSN 2508-8831, eISSN 2586-0585 triangular pattern, and modified double triangular pattern [7][8][9][10][11].…”

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“…Na prática oftalmológica, as distonias faciais mais frequentemente observadas são o blefaroespasmo essencial benigno (BEB) e o espasmo hemifacial (EHF) (4) . As modalidades de tratamento dessas alterações consistem em medicações via oral, intervenções cirúrgicas, aplicação local de toxina botulínica e outros métodos complementares, como psicoterapia (4)(5)(6) . Dentre tais modalidades, a mais consagrada é a aplicação periocular de toxina botulínica tipo A (7) .…”