SILICONE FRONTALIS SLINGS FOR THE CORRECTION OF BLEPHAROPTOSIS - INDICATIONS AND EFFICACY

Purpose: To determine the efficacy of silicone rod frontalis sling pto sis repair in selected patients, Methods: The authors retrospectively studied 35 consecutive patients who underwent silicone sling ptosis re pairs in 61 lids at the University of California, San Francisco. Resul ts: Preoperative diagnoses included congenital ptosis causing developm ental delay or possible amblyopia in children younger than 3 years of age, chronic progressive external ophthalmoplegia, third-nerve palsy, myasthenia gravis, and ocular restriction secondary to glaucoma filter ing valves, With a mean follow-up of 22 months, good-to-excellent fina l lid height was achieved in all 61 lids, Recurrence of the ptosis occ urred in four lids (7%), requiring replacement of the silicone rod in two lids and revision of the original sling in two lids to reach the f inal lid height. Chronic exposure keratopathy without corneal infectio n occurred postoperatively in 9 (15%) of 61 eyes, all in patients with an inadequate or absent Bell phenomenon, Chronic corneal problems did not develop in any of the children. Extrusion of the sling with or wi thout infection occurred in three foreheads (5%) in two patients young er than 15 years of age, Conclusion: Silicone rod is an effective mate rial for use in frontalis suspension in treating severe ptosis with po or levator function. Children younger than 3 years of age with congeni tal ptosis and developmental delay or possible amblyopia can undergo s ilicone frontalis suspension to achieve good visual results, The elast icity and ease of adjustment of the silicone rod are ideal characteris tics for a suspensory material used to correct severe ptosis associate d with a minimal or absent Bell phenomenon, such as in chronic progres sive external ophthalmoplegia, myasthenia gravis, or third-nerve palsy .