Gore-Tex Suture Research Articles

Congenital Ptosis Correction with an Expanded Polytetrafluoroethylene (GORE-TEX) sling: Comparative Study Between Crawford and Fox Techniques

Background: Frontalis suspension is the procedure of choice for surgical management of congenital ptosis associated with poor elevator function. Objective: The aim of the work was to compare the results of two different frontalis suspension surgery techniques, i.e., the Crawford and Fox techniques, using GORE-TEX for the correction of congenital ptosis with poor levator function. Patients and Methods: fifty eyelids of 30 patients with severe ptosis and poor levator function (≤ 4 mm) were randomly divided into two groups: Group A included 26 eyelids of 16 patients corrected with the Crawford technique, and Group B included 24 eyelids of 14 patients corrected with the Fox technique. The results were evaluated and statistically compared. Results: at the end of the follow-up period (18 months postoperatively), most of the patients in both groups (80.8% of group A, 79.2% of group B) achieved good to excellent cosmetic results. The intergroup difference was not statistically significant (P < 0.05). Regarding contour, Group A was 96.2 %, and Group B was 95.8 %. Regarding symmetry, Group A was 88.5%, and Group B was 79.2%. Conclusion: considering the use of the same sling material (GORE-TEX suture), the Crawford and Fox techniques are both safe and effective with comparable results in the correction of severe ptosis with poor levator function.

Refractive Outcomes after Pars Plana Vitrectomy and Scleral Fixated Intraocular Lens with Gore-Tex Suture

To evaluate refractive outcomes after combined pars plana vitrectomy (PPV) and scleral fixation of an intraocular lens (IOL) using Gore-Tex suture. Retrospective cohort study. Fifty-five eyes from 53 patients who underwent PPV with a Gore-Tex sutured IOL from June 2013 through December2017. Patients who underwent combined PPV and scleral fixation of an IOL with Gore-Tex suture were identified. All eyes underwent scleral fixation of either an Akreos A060 or enVista MX60 IOL and were fixated either 2 mm or 3 mm posterior to the limbus. Postoperative manifest refractions were performed at least 3 months after surgery and were compared with preoperative predicted target refraction based on in-the-bag IOL calculations. Subgroup analyses based on sclerotomy placement and IOL models were performed. Postoperative manifest refraction and difference with sclerotomy placement and IOL model. The mean postoperative spherical equivalent (SEQ) was -0.99±1.00 diopters (D). The mean difference in SEQ (ΔSEQ) from preoperative predicted target was -0.64±1.00 D. The IOL was fixated 2 mm posterior to the limbus in 14 eyes and 3 mm in 41 eyes. Within these 2 subgroups, the mean postoperative SEQ was -1.53±1.35 D for fixation 2 mm posterior to the limbus and -0.82±0.83 D for fixation 3 mm posterior to the limbus (P= 0.09). The mean ΔSEQ was -0.43±0.71 D for fixation 3 mm posterior to the limbus and -1.35±1.32 D for fixation 2 mm posterior to the limbus (P= 0.03). The mean amount of surgically induced astigmatism in the overall cohort was 0.77±0.65 D. The mean ΔSEQ and induced astigmatism were similar between IOL models. After combined PPV and Gore-Tex-sutured IOL implantation, mean postoperative refractive outcomes were more myopic when the IOL was fixated 2 mm from the limbus compared with 3 mm from the limbus. No significant difference was found between IOL models. Based on these results, future implant power calculations may be adjusted to approximate preoperative target refraction more accurately.

Scleral Fixation of Intraocular Lenses with Gore-Tex Suture: Refractive Outcomes and Comparison of Lens Power Formulas

To report refractive outcomes of scleral-fixated intraocular lens (IOL) implantation with Gore-Tex (W.L. Gore & Associates, Newark, DE) suture and combined pars plana vitrectomy and compare predicted refractive outcomes among 5 IOL power calculation formulas. Retrospective case series. Patients undergoing scleral-fixated IOL implantation with Gore-Tex suture at our institution between January 2015 and June2018. Comparison of preoperative biometrics with postoperative refraction and calculation of predicted refractive outcome with 5 different IOL formulas. Prediction error and absolute error to compare postoperative refraction with refraction predicted by lens power calculation formulas. Thirty-one eyes of 31 patients were included. All power calculations assumed in-the-bag position of the IOL. The Akreos A060 (Bausch & Lomb, Rochester, NY) was implanted in 23 eyes and the CZ70BD (Alcon, Fort Worth, TX) in 8 eyes, and all lenses were sutured 3 mm behind the limbus. Average postoperative spherical equivalent (SE) was -0.79±0.95 diopters (D). Average prediction error (postoperative SE refraction minus target refraction) was -0.19±0.72 D. Postoperative SE was within 1.0 D of target in 25 of 31 patients (81%) and 2.0 D of target in 31 of 31 patients (100%). The repeated-measures analysis of variance of absolute error by lens power formula was significant (P= 0.012), with Haigis demonstrating greater error. There was no significant difference among Barrett II, Sanders-Retzlaff-Kraff theoretical (SRK/T), Holladay 2, or Hoffer Q. For eyes undergoing pars plana vitrectomy with scleral-sutured IOL implantation, assumption of in-the-bag IOL position when calculating lens power leads to acceptable refractive outcomes. Barrett II, SRK/T, Holladay 2, and Hoffer Q formulas were noninferior to each other.

Abstract 17300: Development and Ex Vivo Validation of Novel Force-Sensing Neo-Tendons for Measuring Chordae Tendineae Tension in the Mitral Valve Apparatus Using Optical Fibers With Embedded Bragg Gratings

Introduction: Very few technologies exist that can provide quantitative data on forces within the mitral valve apparatus. Marker based strain measurements can be performed, but chordae heterogeneity limits utility. Foil-based strain sensors have also been described, but tend to be bulky, limiting the number of chordae that can be measured. Hypothesis: We hypothesize that the use of Fiber Bragg Grating (FBG) sensors—optical strain gauges made of 125 μ m diameter silica fibers— can overcome the critical limitations of previous methods of measuring chordae tendineae forces. Methods: Using FBG sensors, we created a force-sensing neochord that would mimic the natural shape and movement of native chordae tendineae. FBG sensors reflect a specific wavelength of light depending on the spatial period of gratings - when a force is applied, the gratings move relative to one another, changing the reflected light (Fig 1A). This wavelength shift is directly proportional to the force applied. The FBG sensors were housed in a protective sheath fashioned from the outer coil of a 0.025" Amplatz Extra-Stiff guidewire, and attached to the chordae using GoreTex suture (Fig 1B). The function of the force-sensing neochordae were validated in a 3D printed left heart simulator. Results: FBG sensors provided high-fidelity force measurements of mitral valve chordae tendineae at a temporal resolution of 1000 Hz. As ventricular pressures increased, such as in the hypertensive condition, forces on the chordae also increased (Fig 1C). The resolution of FBG sensors allow for increased accuracy of not only chordae tension, but also the rate of change of force (dF/dt) - a parameter critical to determining likelihood of leaflet rupture. Conclusions: FBG sensors are a viable, durable, and high-fidelity technology that can be effectively used to measure mitral valve chordae forces and overcome limitations of other such technologies.

Clinical outcomes of 4-point scleral fixated 1-piece hydrophobic acrylic equiconvex intraocular lens using polytetrafluoroethylene suture.

PurposeTo report the visual outcomes and complications of scleral fixated intraocular lenses (IOLs) using Gore-Tex suture.MethodsThe current study is a retrospective noncomparative case series including patients who underwent scleral fixation of IOL (Akreos AO60) using Gore-Tex suture from August 2015 to March 2017 at a university teaching center. Primary outcome measures were visual acuity and complications at last follow-up.ResultsThe current study included 49 eyes of 48 patients. Mean follow-up duration postsurgery was 6.9 months (range: 0.9–29.4 months). The indications for secondary IOL surgery were dislocated IOL in 16/49 (33%), subluxed IOL in 9/49 (18%), dislocated or subluxed crystalline lens in 9/49 (18%), traumatic cataract in 8/49 (16%), and complicated cataract surgery in 7/49 (14%). Mean best-corrected logMAR visual acuity improved from 1±0.7 (20/200 Snellen equivalent) preoperatively to 0.5±0.5 (20/63 Snellen equivalent) at last follow-up. There were no intraoperative complications noted. Early postoperative complications included significant persistent corneal edema (longer than 1 week) in 4/49 (8.2%), ocular hypertension (intraocular pressure ≥25 mmHg) in 8/49 (16.3%), hypotony (intraocular pressure ≤5 mmHg) in 6/49 (12.2%), cystoid macular edema 3/21 (6.1%), IOL tilt 2/49 (4.1%), hyphema in 2/49 (4.1%), and vitreous hemorrhage in 5/49 (4.8%). There was one case of recurrent retinal detachment. One patient presented with an erosion of the Gore-Tex suture through the conjunctiva resulting in a purulent scleritis 6 months after the initial surgery, and was managed with removal of the IOL, debridement, and cryotherapy. Forty-one of 49 patients completed 3-month follow-up, among which visual acuity improved, deteriorated, or remained same compared to baseline in 27/49 (55.1%), 8/49 (16.3%), and 6/49 (12.2%) eyes, respectively.ConclusionIn the current study, visual acuity outcomes were generally favorable. The complications were largely transient. Significant complications included a suture-related infection, which required removal of the IOL, and a recurrence of a retinal detachment.

Scleral Fixation of Posterior Chamber Intraocular Lenses Using Gore-Tex Suture: Clinical Outcomes From a Single Institution

Purpose: The purpose of this article is to examine the clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture at our institution. Methods: A retrospective chart review was conducted of patients who underwent scleral fixation of an IOL with Gore-Tex suture with concurrent pars plana vitrectomy. Intraoperative and postoperative complications were assessed. Results: Seventy-four eyes of 74 patients were included with a mean follow-up interval of 210 days (range, 33–720 days). The mean best-corrected visual acuity improved from 20/480 (1.38 logarithm of the minimum angle of resolution [logMAR]) preoperatively to 20/78 (0.59 logMAR) postoperatively ( P &lt; .001). Indications included dislocated lens implant (42), aphakia without capsular support (18), and subluxation of crystalline lens (14). Bausch and Lomb Akreos AO60 IOL was implanted in 52 eyes, Alcon CZ70BD in 15, and Bausch and Lomb enVista MX60 in 6. Postoperative complications included temporary ocular hypertension in 9 eyes (12%), temporary hypotony in 7 (9%), cystoid macular edema in 3 eyes (4%), corneal decompensation in 2 eyes (3%), IOL dislocation requiring exchange in 1 case (1.4%), vitreous hemorrhage in 2 cases (3%), and retinal detachment in 2 cases (3%). There were no cases of postoperative suture breakage or erosion, endophthalmitis, or hyphema. Conclusions: The use of Gore-Tex suture in scleral fixation of posterior chamber IOLs was well tolerated at a mean follow-up interval of 210 days. There were no suture-related complications.

COMBINED PARS PLANA VITRECTOMY AND SCLERAL FIXATION OF AN INTRAOCULAR LENS USING GORE-TEX SUTURE: One-Year Outcomes.

To report the 1-year clinical outcomes of combined pars plana vitrectomy and ab externo scleral fixation of an intraocular lens using Gore-Tex suture. Retrospective, interventional case series. Outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 1 year. Eighty-four eyes of 83 patients were identified. The mean best available visual acuity improved from 20/782 preoperatively to 20/65 postoperatively (P < 0.001). The mean follow-up was 598 ± 183 days (median 533 days, range 365-1,323 days). There were no intraoperative complications noted. A Bausch & Lomb Akreos AO60 intraocular lens was implanted in 77 eyes and an Alcon CZ70BD in 7 eyes. Postoperative complications included transient vitreous hemorrhage in six eyes (7.1%), cystoid macular edema in four eyes (4.8%), ocular hypertension in three eyes (3.6%), hyphema in two eyes (2.4%), and transient corneal edema in two eyes (2.4%). There were no cases of postoperative endophthalmitis, suture erosion/breakage, hypotony, retinal detachment, suprachoroidal hemorrhage, choroidal detachment, uveitis-glaucoma-hyphema syndrome, or persistent postoperative inflammation during the follow-up period. Combined pars plana vitrectomy and ab externo scleral fixation of an intraocular lens with Gore-Tex suture was well tolerated at a minimum of 1-year follow-up. No suture-related complications were encountered.

Suture snare technique for scleral fixation of intraocular lenses and capsular tension devices

Polytetrafluoroethylene (Gore-Tex) suture is preferred for scleral fixation of intraocular lenses or capsular tension devices as it is more resilient to breakage than polypropylene 10–0. However, manipulation of the thick...

Pigmentary Reaction around Gore-Tex Suture in a Scleral-Fixated Intraocular Lens

Pigmentary Reaction around Gore-Tex Suture in a Scleral-Fixated Intraocular Lens

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis.

Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirements and steps developed for the above training purpose. Over a series of four animal ethics' approved experiments, the technique of robotic-assisted laparoscopic autotransplantation of the kidney was developed in Amsterdam live pigs (60-70kg). The surgery was based around the vascular anastomosis technique described by Menon et al. This non-survival porcine training model is targeted at transplant surgeons with robotic surgery experience. Under general anesthesia, each pig was placed in lateral decubitus position with the placement of one robotic camera port, two robotic 8mm ports and one assistant port. Robotic docking over the pig posteriorly was performed. The training platform involved the following procedural steps. First, ipsilateral iliac vessel dissection was performed. Second, robotic-assisted laparoscopic donor nephrectomy was performed with in situ perfusion of the kidney with cold Hartmann's solution prior to complete division of the hilar vessels, ureter and kidney mobilization. Thirdly, the kidney was either kept in situ for orthotopic autotransplantation or mobilized to the pelvis and orientated for the vascular anastomosis, which was performed end to end or end to side after vessel loop clamping of the iliac vessels, respectively, using 6/0 Gore-Tex sutures. Following autotransplantation and release of vessel loops, perfusion of the graft was assessed using intraoperative indocyanine green imaging and monitoring urine output after unclamping. This training platform demonstrates adequate face and content validity. With practice, arterial anastomotic time could be improved, showing its construct validity. This porcine training model can be useful in providing training for robotic intracorporeal vascular anastomosis and may facilitate confident translation into a transplant human recipient.

Novel Surgical Approach for Fixation of a Posterior Chamber Intraocular Lens Using Gore-Tex Suture.

Novel Surgical Approach for Fixation of a Posterior Chamber Intraocular Lens Using Gore-Tex Suture.

Manual Braiding of GoreTex Neochords to Ensure Correct Length in Mitral Valve Repair

Ascertaining the correct length of neochords during mitral valve repair is challenging. We describe a modified technique of chordal replacement where a GoreTex (W.L. Gore and Assoc, Inc, Flagstaff, AZ, USA) sutures are repeatedly tied so as to braid the suture to the optimal length before sutures are passed through the mitral leaflet. The length of the braided chord remains fixed when tying on the atrial side. For bileaflet repairs, a second suture is incorporated into the initial chord to create a "Y" braided neo-chord configuration. This technique facilitates precision in mitral repair.

Suture Choice in Lumbar Dural Closure Contributes to Variation in Leak Pressures: Experimental Model.

Open-label laboratory investigational study; non-animal surgical simulation. The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. Incidental durotomy leading to persistent cerebrospinal fluid leak adds considerable morbidity to spinal procedures, often complicating routine elective lumbar spinal procedures. Using an experimental durotomy simulation, the authors compare the strength of closure using Gore-Tex with other suture types and sizes, using various closure techniques. A comparison of dural closures was performed through an analysis of the peak pressure at which leakage occurred from a standardized durotomy closure in an established cerebrospinal fluid repair model with a premade L3 laminectomy. Nurolon was compared with Gore-Tex sutures sizes (for Gore-Tex, CV-6/5-0 and CV-5/4-0 was compared with Nurolon 4-0, 5-0, and 6-0). Thirty-six trials were performed with Nurolon 4-0, 5-0, and 6-0, whereas 21 trials were performed for 4-0 and 5-0 Gore-Tex. The mean peak pressure at which fluid leakage was observed was 21 cm H2O for Nurolon and 34 cm H2O for Gore-Tex. Irrespective of suture choice, all trials were grouped by closure technique: running suture, locked continuous, and interrupted suture. No significant difference was noted between the groups. For each of the 3 trials groups by closure technique, running, locked continuous, and interrupted, Gore-Tex closures had a significantly higher peak pressure to failure. Interrupted Gore-Tex was significantly higher than Interrupted Nurolon (P=0.007), running Gore-Tex was significantly higher than running Nurolon (P=0.034), and locked Gore-Tex was significantly higher than locked Nurolon (P=0.014). Durotomy closure in the lumbar spine with Gore-Tex suture may be a reasonable option for providing a watertight closure. In this laboratory study, Gore-Tex suture provided watertight dural closures that withstood higher peak pressures.

V2-02 TOTAL AUTOLOGOUS FASCIA LATA ANTERIOR REPAIR AND APICAL SUSPENSION: A NEW TECHNIQUE

You have accessJournal of UrologyFemale Pelvic Medicine1 Apr 2017V2-02 TOTAL AUTOLOGOUS FASCIA LATA ANTERIOR REPAIR AND APICAL SUSPENSION: A NEW TECHNIQUE Christian Twiss, Miguel Craig, Frank Lin, and Joel Funk Christian TwissChristian Twiss More articles by this author , Miguel CraigMiguel Craig More articles by this author , Frank LinFrank Lin More articles by this author , and Joel FunkJoel Funk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.390AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The reclassification of vaginal mesh to a high risk device for treatment of pelvic organ prolapse prompted our group to consider alternative graft materials. Based on the similar success rates and durability of mesh and autologous fascia in the treatment of female stress urinary incontinence (SUI), our objective was to develop a transvaginal repair for anterior and apical vaginal prolapse with the use of only autologous fascia lata graft thereby avoiding synthetic mesh, allograft and xenograft. METHODS The video demonstrates our technique for Autologous Anterior and Apical Pelvic Organ Prolapse (AAA-POP) repair. Autologous fascia lata of suitable size (4 X 12 cm up to 5 X 14 cm) is harvested through a minimally invasive, lateral upper thigh incision. The graft is then cut into 3 strips (1cm X 12cm up to 1.3 cm X 14cm) and reassembled with one strip affixed to the bladder neck and sutured to the obturator internus fascia with 0-vicryl. The other 2 strips are sutured to the strip at the bladder neck with CV-2 Gore-Tex suture, crossed at the level of the vaginal apex, and sutured to the sacrospinous ligaments with 0-PDS. Patients were followed with subjective SEAPI scores, visual analog pain (VAP) scores (range 0-10), pelvic examination (Baden-Walker grading), and examination of the thigh harvest site. RESULTS The AAA-POP procedure has been performed on 5 patients with a mean age of 61 and a mean follow-up of 2 months. Apical uterine suspension was performed in 3/5 patients and the other 2/5 patients were status post hysterectomy. Symptoms of pelvic organ prolapse resolved in all 5 patients, but 1 patient had an asymptomatic grade 1 cystocele without apical prolapse at 3 months follow-up. No patients complained of SUI or urge incontinence on SEAPI scoring. 1 patient required lysis of a concurrent pubovaginal sling 2 weeks postoperatively with resolution of urinary retention, and 1 patient had mild obstructive symptoms on SEAPI scoring. 2 patients developed thigh hernias postoperatively, and the mean VAP score at the harvest site was 1.8 for all patients. CONCLUSIONS Autologous Anterior and Apical Pelvic Organ Prolapse (AAA-POP) repair with fascia lata is a feasible option in the post-mesh era and appears to be safe and efficacious with short-term follow-up. Longer follow-up is needed to determine long term success and possible complications of the procedure. Although self-reported pain scores were low, patients should be aware of the risk of residual pain at the harvest site and possible development of a thigh hernia. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e133 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Christian Twiss More articles by this author Miguel Craig More articles by this author Frank Lin More articles by this author Joel Funk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The Gore-Tex Suture in Periareolar Closure: A Modified Closure Technique.

In breast reduction and mastopexy procedures, the periareolar closure forms a vital component of the surgery. Periareolar closures completed with an absorbable suture may be prone to significant widening, hypertrophy and/or areolar distortion. In an effort to avoid this, some surgeons use a non-absorbable/permanent suture material [Franco (Arch Plast Surg 41 (6): 728-733, 2014)]. Hammond (Plast Reconstr Surg 119 (3):804-809, 2007) recommends the use of a Gore-Tex® suture for this purpose in view of the supple, pliable nature of the material; however, there remain at least occasional instances of infection and extrusion of the knot used to tie off the Gore-Tex "purse-string" [Franco (Arch Plast Surg 41 (6): 728-733, 2014); Salgarello (Aesthet Plast Surg 37 (5):1061-1062, 2013)]. We describe a method of securing the suture ends, which avoids the creation of a bulky knot, thus minimising the risk of infection and suture extrusion. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Investigation of Sacral Needle Depth in Minimally Invasive Sacrocolpopexy

The aims of the study were to optimize surgical safety and to minimize vertebral disc puncture during sacral needle placement at the time of minimally invasive sacrocolpopexy. Cadaveric studies report that the anterior longitudinal ligament (ALL), which covers the vertebral disc and vertebrae, has a reported thickness of only 1.4 to 2.3 mm at L5-S1. Intervertebral disc puncture can accelerate disc degeneration, disc herniation, and loss of disc height, a risk that may be avoidable. After institutional review board approval, research consent was obtained from women undergoing primary laparoscopic sacrocolpopexy. Intraoperatively, sacral sutures were placed in the ALL with a 1.5 cm diameter CV-2 needle using Gore-Tex suture. Depth measurements were collected using a laparoscopic ultrasound transducer positioned on the sacral promontory (SP) between the 2 ends of the needle visible through the ALL. Two still-frame US images of the single needle were taken using the BK Medical software. Needle depth was calculated by measuring the distance from the top of the ALL to the needle. Two satisfactory intraoperative images were obtained for all 9 participants. The mean needle depth at the SP was 3.96 mm. The interpatient needle depth varied from 2.07 to 9.04 mm. In most participants (78%), the sacral needle depth exceeded 2.3 mm, suggesting that there may be risk to sacral suture placement without depth guidance at the promontory. During minimally invasive sacrocolpopexy, the depth of the ALL and the placement of the needle at the SP may result in inadvertent disc penetration. Surgeons should be conscious of the minimal depth of the ALL and consider placing the suture below the promontory to avoid the disc.

Evaluation of expanded polytetrafluoroethylene (Gore-Tex) suture in frontalis suspension in severe congenital upper-eyelid blepharoptosis

Aim The aim of the study was to evaluate the efficacy and complications of a new expanded polytetrafluoroethylene (Gore-Tex) suture in frontalis suspension in severe congenital upper-eyelid blepharoptosis with poor levator function (4 mm or less) wherein fascia lata is difficult to harvest in young children. Patients and methods In a retrospective study, frontalis suspension was performed in patients with severe congenital ptosis in whom the levator function was 4 mm or less. The procedure was performed in 62 eyes of 40 patients between February 2010 and March 2013. The mean follow-up duration was 12 ± 2 months. Forty patients were included in this study, 26 girls and 14 boys, with an average age of 2.8 ± 0.1 years. Frontalis suspension was performed with the open approach using a single pentagon suture (Fox procedure). Results The average margin reflex distance was −0.55 mm preoperatively, which improved to +2.2 mm at 6 months postoperatively ( P P = 0.005). Six eyes (10%) showed complete recurrence. Twenty-two eyes (35%) experienced partial recurrence. The average period of recurrence was 6.56 months. Postoperative complications such as suture granuloma, infection, exposure, lagophthalmus, and overcorrection occurred in a few patients. Conclusion The use of the new version of Gore-Tex suture as a suspensory material in frontalis suspension in severe congenital upper-eyelid blepharoptosis is safe and effective and can be recommended for clinical use.

Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profile

Background/aimsTo report the short-term safety profile and clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture.MethodsRetrospective, interventional case series. 85 eyes of 84 patients undergoing ab externo...

Incidence and management of cerebrospinal fluid fistulas in 336 multilevel laminectomies with noninstrumented fusions.

Background:The incidence (e.g., 3–27%) and the types of cerebrospinal fluid (CSF) fistulas occurring during multilevel lumbar laminectomy with noninstrumented spinal fusions varies.Methods:From 2000 to 2015, we retrospectively evaluated the incidence/etiologies of CSF fistulas occurring for 336 patients undergoing average 4.7 laminectomies with average 1.4 level noninstrumented fusions over a 15 year period. The varied etiologies of CSF leaks included; ossification of the yellow ligament (OYL) extending through the dura, postoperative surgical scar, iatrogenic traumatic leak, epidural steroid injections (ESI), resection of synovial cysts, and the removal of intradural tumors. Techniques for primary repairs included combinations of; 7-0 Gore-Tex (Newark, Delaware, USA) sutures, micro-dural staples, muscle patch/other (e.g., bovine pericardial) grafts, fibrin sealants/glues (e.g., Tisseel; Baxter International Inc., Westlake Village, CA, USA), and Duragen (Integra LifeSciences, Hawthorne, NY, USA) including both the thin and suturable types.Results:The etiologies of CSF fistulas in descending order included: Epidural spinal injections (ESI) (7 patients), synovial cysts (6 patients), OYL (5 patients), and equally for postoperative scar and intradural tumors (3 patients). CSF fistulas occurred in 24 (7.14%) of 336 patients; this frequency was reduced to 4.2% when ESI and intradural tumors were excluded.Conclusion:CSF fistulas occurred in 7.14% of 336 patients undergoing average 4.7 multilevel laminectomies with average 1.4 level noninstrumented fusions attributed to a lumbar stenosis with mild/moderate instability. The dural repair addressed seven prior ESI, six synovial cysts, five OYL, and operative scarring and intradural tumors (three apiece). Knowing the pathologies contributing to CSF fistulas should help the surgeon to better anticipate and treat these fistulas.

Periareolar augmentation mastopexy with interlocking gore-tex suture, retrospective review of 50 consecutive patients.

BackgroundPeriareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result.MethodsA retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study.ResultsThe age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy).ConclusionsAs a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.