One medial triangular Tutoplast sling as a frontalis suspension for adult myogenic blepharoptosis

Abstract

The treatment of choice for medium to severe blepharoptosis with minimal or no levator function is frontalis suspension with a sling, using a rectangular or rhomboid sling placement technique. We describe the short-term, follow-up results of frontalis suspension surgery for adult myogenic blepharoptosis using Tutoplast, a commercially available fascia lata allograft. We conducted a consecutive, interventional case study. All adult (>25 years of age) patients operated for non-traumatic myogenic ptosis during a 1-year period were included. All underwent frontalis suspension using one medial triangular Tutoplast sling. Success was judged according to lid position and complications. Successful surgical results were judged by lid level, lid symmetry and lid contour. During a mean follow-up of 9 months, the success rate was 91% in all three criteria and 100% in at least two out of three. No major complications were observed. The most prevalent minor complication was the need for lubrication treatment in 26% of the operated patients. The use of Tutoplast for frontalis suspension in cases of adult myogenic ptosis is safe and has a high success rate in the early postoperative period. Further large-scale studies are necessary to ascertain the longterm results and the applicability of this material to other indications.