Outcomes for expanded polytetrafluoroethylene strip in frontalis suspension surgery

ABSTRACT

Purpose

This study evaluates surgical outcomes and complication rates of frontalis suspension with expanded polytetrafluoroethylene (ePTFE).

Methods

This retrospective cohort study reviewed all patients undergoing frontalis suspension surgery using ePTFE as the sling material from January 1 2012 to March 3 2020 by a single surgeon at a single academic center. Two different surgical techniques were evaluated in the placement of the sling material. Demographic, clinical, and operative data were extracted. Outcome data including postoperative lid height, reoperation, and complication rate were extracted for the cohort and compared between the two surgical techniques. Descriptive statistics were utilized.

Results

Sixty-four eyes from 49 unique patients were included in this study. Forty-three (67.2%) patients had isolated congenital blepharoptosis; 14 (21.9%) had blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES); and 2 (3.1%) had cranial nerve III palsy. Fifty-one (79.7%) patients had no prior blepharoptosis surgery. Lid crease incision and stab incision techniques were utilized for 24 (37.5%) and 40 (62.5%) eyes, respectively. Overall, 21 (32.8%) eyes required reoperation with ePTFE to achieve appropriate eyelid height or contour. Only one patient experienced implant infection, requiring removal of ePTFE sling after a second reoperation. There were no cases of implant exposure or granuloma formation noted during the study period.

Conclusion

An ePTFE strip soaked in cefazolin prior to utilization in surgery is a viable material for frontalis suspension surgery, with a lower infectious or inflammatory complication rate than previously reported. However, reoperation rate was still relatively high.

KEYWORDS:

• Ptosis
• frontalis suspension surgery
• ePTFE
• frontalis sling

Acknowledgements

This study adhered to the tenets of the Declaration of Helsinki and was performed in accordance with the Health Insurance Portability and Accountability Act. The study was approved by the Institutional Review Board at the University of California, San Francisco. Patient consent was obtained for usage of patient photographs.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Meeting presentation

Podium presentation at American Society of Ophthalmic Plastic Surgeons (ASOPRS) Spring Meeting 2022, White Sulphur Springs, West Virginia, USA.

Additional information

Funding

This research was supported, in part, by the UCSF Vision Shared Resource Core Grant [NIH/NEI P30 EY002162] and an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology at UCSF.