Frontalis suspension for pediatric congenital ptosis in Asian eyes offers functional success

Ophthalmology. 2009;116(7):1405-1414.

Asian children had successful long-term functional outcomes following frontalis suspension using fascia lata autografts for pediatric congenital ptosis, but long-term cosmetic success was not achieved, according to a study.

The reasons for the lack of long-term cosmetic success were numerous, the study authors said.

"This deterioration in cosmetic outcome was the result of gradual elevation of lid height, medial inversion of eyelashes and poor lid creases, possibly resulting from contracture of the grafted fascia lata and the anatomic characteristics of Asian eyelids," they said.

The retrospective, observational case series looked at 239 patients aged 3 to 15 years old. All patients underwent frontalis suspension using fascia lata autografts. There was a minimum of 6 months follow-up; the median follow-up was 18 months.

Photographs were used to review and score functional and cosmetic success. Medical charts were also used to review functional success.

The researchers found functional success rates at 100% at 1 month postop and 94% at last follow-up.

At 1 month, success rates of the cosmetic measurements of lid contour, symmetry of height bilaterally and lid crease were more than 90%. However, by 6 months, cosmetic success rates for those parameters had fallen significantly, the authors said.