Treatment of congenital ptosis by frontalis suspension with monofilament polypropylene suture: Results of a study of 21 cases

Introduction.- Frontalis suspension of the upper eyelid using suture in the treatment of congenital ptosis has long been considered a temporary solution when there is a risk of amblyopia. It helps to clear the visual axis pending further surgery after the age of 4 years. Polypropylene suture (Prolene (R)), which is an inert material with optimum scarring properties and tensile strength and good knot stability, has shown very encouraging functional and aesthetic results and low recurrence rates. Material and methods.- Retrospective descriptive study of a series of 21 patients, between January 2008 and December 2012, with severe congenital ptosis and poor or no function of the levator muscle of the upper eyelid. Results. In our series, the recurrence rate of ptosis was 14.3% with a mean follow-up of 25.9 +/- 10.8 months. We found 3 cases of under-correction, and one case of granulomatous inflammation with infection. Discussion.- The use of polypropylene suture seems to be a very good alternative to conventional materials for suspension, such as fascia lata, temporalis fascia and polytetrafluoroethylene (PTFE or Goretex (R)). The advantages of this technique are the ease of removal, low cost and lower associated morbidity. Conclusion.- Eyelid suspension with polypropylene suture is an easy, rapid, reversible and inexpensive technique. The results in the short and medium terms are very encouraging, and we need longer follow-up to evaluate the long-term results. (C) 2014 Elsevier Masson SAS. All rights reserved.