Chulalongkorn Medical Journal


Background : Congenital blepharoptosis is a common eyelid problem.The treatment mostly used is frontalis suspension due to poordevelopment of levator muscle. Frontalis suspension can beachieved in many ways such as autogenous fascia lata suspension,frontalis muscle transfer, synthetic material suspensionincluding suture materials. Recurrence can be anticipated anywayin all procedures. Frontalis suspension using suture materialshas been done for a long time in King Chulalongkorn MemorialHospital since most patients were too young to use autogenousfascia lata. We would like to evaluate the recurrence rate andassociated factors that influence the outcome.Objective : To study recurrence rate of frontalis suspension procedure andassociated factors that influence the outcome.Design : Descriptive studySetting : Department of Ophthalmology, Faculty of Medicine, ChulalongkornUniversity and King Chulalongkorn Memorial HospitalMaterial and Method : Definition of recurrent blepharoptosis, surgical failure, recurrenttime were denoted. Twenty-three patients diagnosed withcongenital blepharoptosis corrected by primary frontalissuspension using nylon suture material at King ChulalongkornMemorial Hospital during January 2004 and December 2008 werereviewed. Data collected from surgical records, and variablefactors were assessed.Results : Twenty-three eligible patients were recruited into the study.Twelve out of 23 cases had recurrence (52.2%). The age grouphave association with recurrence (r = 0.3), p = 0.032, [95% CI,0.006 - 0.802]. The age group ≤ 2 years old seemed to havehigher recurrence rate in contrast to the age group > 2 years old(68.8% vs 31.2%). Overall median time to recurrence was27.5 months (SD 15.1), [95%CI, 0-57.0]. There was no statisticallysignificant difference of recurrence rate among patients’ age group,gender, laterality and preoperative margin-reflex distance1 (MRD1).Conclusion : Suture frontalis suspension had high recurrence rate with overallmedian survival time at 27.5 months. However, with nearly2.5-year-survival, it might benefit very young children who needsurgical correction but in whom autogenous fascia lata suspensioncould not be done. The age group was the only associated factorthat influenced the outcome in the study.


Faculty of Medicine, Chulalongkorn University

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