Abstract
Aim: To evaluate the use of Straight needle threading technique to perform frontalis sling by silk suture material as a surgical correction of severe blepharoptosis cases. Settings and Design: a prospective study was performed on patients who underwent 3-0 silk frontalis suspension using a Straight needle threading technique with an average of 8 months follow up period. Baker’s criteria for satisfactory results was used in which the correction of > = 1 mm from the normal side (or corrected side in bilateral ptosis). Patients and Methods: An eighty seven eyes in 67 patients were done, 25 eyes were operated on under local anaesthesia and 62 eyes under GA, 20 cases bilateral and 47 cases unilateral, 55.2% males (37 cases) and 44.8% females (30cases). The average age was 12 years (range 2-70 years). Statistical analysis was done by using the frequency values analysed by the program Statistical package for social sciences (SPSS) version 20 to analyse the results. Results: it was satisfactory in 76.4%, unsatisfactory in 23.6%, overcorrection 3.5%, under correction 15.3%, Entropion 0%, Lagophthalmus 4.8%, exposure keratitis 0%. Conclusion: the use of silk suture by straight needle threading technique is fast, easy, and low cost method to correct a complex problem like sever ptosis with a comparable aesthetic and functional results to other non- autologous materials, with good safety profile.
Highlights
Blepharoptosis is a combined problem in having functional and aesthetic components.[1,2] The functional problem is due to blocking of the visual field but the aesthetic problem has more impact on the patient's psychology and life, this impact is magnified in the third world by the lack of family orientation and the delay in seeking medical advice which make the patient's especially children under the pressure of teasing from anger brothers or friends
Frontalis sling by silk suture surgery was done on 87 eyes in 67 patients; 25 eyes under local anaesthesia and 62 eyes under general anaesthesia (GA), 20 cases bilateral and 47 cases unilateral
Entropion and exposure keratitis were not found in the present study, on the other hand, there was problems with lash eversion in 15% of the cases
Summary
Blepharoptosis is a combined problem in having functional and aesthetic components.[1,2] The functional problem is due to blocking of the visual field but the aesthetic problem has more impact on the patient's psychology and life, this impact is magnified in the third world by the lack of family orientation and the delay in seeking medical advice which make the patient's especially children under the pressure of teasing from anger brothers or friends. In teenagers and adults, ptosis correction by using synthetic materials is easy to be done as outpatient procedure, saving time and money for people especially those traveling from far distances. A few patients choose autologous tissue as additional scars may present with donor site morbidity which is not accepted in Iraqi society especially in females. The cost of using autologous tissue is another detrimental factor for it needs an additional procedures as harvesting the fascia is difficult under local anaesthesia. The objective of the present article is to evaluate the use of silk suture in the management of severe ptosis by frontalis sling threaded straight needle. A simple solution to a complex problem which takes only a few minutes in the outpatient surgical unit or may be done under general anaesthesia
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