Korean J Ophthalmol.  2013 Oct;27(5):311-315. 10.3341/kjo.2013.27.5.311.

Ptosis Repair Using Preserved Fascia Lata with the Modified Direct Tarsal Fixation Technique

• Suh JY
• Ahn HB

• KMID: 1707283
• DOI: http://doi.org/10.3341/kjo.2013.27.5.311

Abstract

PURPOSE
To evaluate the clinical outcome of frontalis sling operation using preserved fascia lata with modified direct tarsal fixation in congenital ptosis patients.
METHODS
Forty-seven congenital ptosis patients (60 eyes) who underwent a frontalis sling operation using preserved fascia lata with modified direct tarsal fixation method between March 2001 and December 2008 with a mean follow-up time of 52 months (range, 26 to 122 months) were included in this study. The medical records were reviewed retrospectively.
RESULTS
A retrospective chart review was conducted in patients who were diagnosed with congenital ptosis and underwent frontalis suspension surgery using preserved fascia lata with modified direct tarsal fixation from 2001 through 2008 at Dong-A University Hospital. The patients were 34 males and 14 females. The age of the patients ranged from 1 to 18 years with an average age of 4.51 years. At a mean follow-up of 60 months, good final results were achieved in 46 eyes (76.6%), fair in 8 eyes (13.3%), and poor in 6 eyes (10%). The poor results consisted of undercorrection of 1 eye and recurrence in 5 eyes. The accumulative survival rate was 87.2%, with all recurrences occurring within 12 months postoperatively.
CONCLUSIONS
Frontalis sling operation by preserved fascia lata with modified direct tarsal fixation appears to be an effective treatment for severe congenital ptosis, showing good long term results.

Keyword

Blepharoptosis; Congenital ptosis; Frontalis sling operation; Preserved fascia lata; Tarsal fixation

MeSH Terms

Adolescent
Blepharoplasty/*methods
Blepharoptosis/congenital/*surgery
Child
Child, Preschool
Fascia Lata/*transplantation
Female
Follow-Up Studies
Graft Survival
Humans
Infant
Male
Recurrence
Retrospective Studies
*Suture Techniques
Transplantation, Autologous

Figure

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  Fig. 1 (A) The ends of the two pieces of fascia lata were anchored to the upper tarsus with 6-0 nylon suture. (B) A Kelly was inserted into the suprabrow incision, grabbing the free end of the sutured fascia lata. (C) The ends of fascia lata were pulled through the sides of the suprabow incisions.

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  Fig. 2 The cumulative survival curve. The cumulative survival rate was 87.2%. Recurrence occurred after a mean of 3.7 ± 4.6 months.

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  Fig. 3 Pictures of one patient before (A) and after (B) the surgery. The degree of ptosis was moderate and surgical outcome was good.

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