Comparison of materials used in frontalis suspension

Objective: To compare various materials used in frontalis suspension surger y for incidence of infection and/or granuloma formation and incidence of re current ptosis. Design and Methods: A retrospective medical record analysis was performed f or 102 frontalis suspension operations performed on 43 patients between Jan uary 1, 1991, and December 31, 1996, at Indiana University Medical Center, Indianapolis. Materials used for surgery were compared for incidence of inf ection and/or granuloma formation and incidence of recurrent ptosis. Materi als included autogenous fascia lata, banked fascia lata, monofilament nylon , braided polyester, expanded polytetrafluoroethylene, and polypropylene. Results: Infection and/or granuloma formation occurred in 10.8% of all fron talis suspensions and in less than 10.0% for each material used except expa nded polytetrafluoroethylene. Five (45.5%) of the 11 frontalis suspensions using expanded polytetrafluoroethylene required removal of the material bec ause of suspected infection. Ptosis recurred in 32 cases (31.4%). Low incid ence of recurrence was found with autogenous fascia la ta and expanded poly tetrafluoroethylene. Conclusions: Of the materials compared in this study, autogenous fascia lat a may be the material of choice for frontalis suspension surgery in congeni tal ptosis. Other materials are useful for temporary eyelid elevation. All materials carry the risk of potential infection and/or granuloma formation.