Content area
Full text
From the Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India.
The authors have no financial or proprietary interest in the materials presented herein.
Introduction
Blepharoptosis is drooping of the upper eyelid, which may be congenital or acquired after birth. Correction of blepharoptosis is considered a challenge to oculoplastic surgeons.1-3 An ideal sling surgery should result in eyelids that are not deformed and are perfectly matched in all positions of gaze, normal blinking movement synchronous in the two eyes, eyelid folds that are of normal contour and are equal on both sides, eyelids that remain closed during sleep, and corneas that remain free of exposure keratitis. However, these results are less commonly seen, especially in sling surgery.
The role of sling surgery for ptosis correction is both therapeutic and cosmetic. Frontalis suspension is a surgical procedure that is performed to address myogenic and aponeurotic ptosis. It creates a link between the frontalis muscle and the tarsus of the upper eyelid that improves ptosis. Eyelid elevation is then performed with the use of frontalis muscle. Frontalis suspension is indicated for severe ptosis (> 4 mm) with poor levator function (< 4 mm), Marcus-Gunn jaw-winking syndrome, blepharophimosis syndrome, ptosis associated with third nerve palsy, and an unsatisfactory result from previous levator resection.
Several materials have been used for frontalis sling surgery. Autologous4-7 or banked8-14 fascia lata is considered ideal for sling surgery because it has a long-lasting effect and functional success has been reported to be nearly 94%. Moreover, it has a low complication rate. However, there are difficulties in its harvesting and more time is required to recover from the leg wound and resultant postoperative scarring.
Several synthetic materials have become available in the armamentarium of the oculoplastic surgeons that include polypropylene15,16 monofilament nylon suture,16-18 Mersilene mesh (Ethicon, Somerville, NJ),19-25 GORE-TEX (W. L. Gore & Associates, Newark, DE),26,27 and silicone,28-37 which are being used more frequently compared to fascia lata. Use of these materials is not free from complications. We report our results and complications associated with the use of silicone rod (Aurosling, 0.92-mm diameter; Aurolab, Madurai, India).
Patients and Methods
This is a retrospective observational cohort study of patients undergoing surgery from September 2008 to August 2013 by a single surgeon (RKB). All...