Abstract
Purpose. To describe the long-term results of frontalis suspension using autogenous fascia lata in children with congenital ptosis under 3 years old. Methods. Forty three-eyes of 35 patients were enrolled in the study. Frontalis suspension using autogenous fascia lata was performed in all patients. The postoperative eyelid level, ptosis recurrence, visual acuity, and cosmetic results were evaluated. Results. The mean age of the patients was 16.8 ± 9 months (7–36 months). The mean follow-up time was 52.8 ± 15 months (14–95 months). All patients had good (ptosis <2 mm) or moderate (2-3 mm ptosis) eyelid level after the operation. All patients achieved satisfactory cosmetic results. Succesfull harvesting was performed in all cases and no additional materials or surgical manipulation were needed during the surgery. Conclusion. Frontalis suspension using autogenous fascia lata can be used in children under 3 years old without harvesting problems. Surgical experience and good knowledge of anatomy are important factors for successful results after the surgery.
Highlights
Congenital ptosis has negative effects on the psychological development of a child [1, 2]
If there is no levator function or the levator function is less than 4 mm, the most effective surgical approach is suspension of the upper lid to the frontal muscle [3]; in this way, the upper eyelid is elevated upon raising the brow
There is a serious risk of amblyopia if the upper lid obscures the visual axis in children with congenital ptosis [13]
Summary
Congenital ptosis has negative effects on the psychological development of a child [1, 2]. Congenital ptosis should be corrected in the early years of childhood, and amblyopia treatment should begin as soon as the diagnosis is established. Either there is no levator function or the levator function is less than 4 mm [3] In these patients, the diagnosis is established if the upper lid cannot come down to lower limbus and stays in its upper position when looking down [4]. If there is no levator function or the levator function is less than 4 mm, the most effective surgical approach is suspension of the upper lid to the frontal muscle [3]; in this way, the upper eyelid is elevated upon raising the brow
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