Cosmetic and functional outcomes of frontalis suspension surgery using autologous fascia lata or silicone rods in pediatric congenital ptosis

PURPOSE: Cosmetic and functional outcomes of frontalis suspension surgery using autologous fascia lata (FL) or silicone rods (SRs) in pediatric congenital ptosis. DESIGN: Retrospective case series. STUDY SUBJECTS: Patients with congenital ptosis, aged 18 years or younger, during the period under study (2005–2011) at the Singapore National Eye Centre. METHODS: Review of case records for functional and cosmetic outcome measures after frontalis suspension surgery using either SRs or autologous FL. RESULTS: A total of 18 patients were studied (14 eyelids had FL, 16 eyelids had SRs) with mean ages of 7.1 (range 5–12) and 7.2 (range 4–18) years for the FL and SR groups, respectively. Mean follow-up period was 41.6 (range 11.2–77.9) and 48.6 (16.1–87.4) months, respectively. Patients in the FL group had better functional and cosmetic results compared to those in silicone group, with no recurrence of ptosis. More complications were experienced by patients in the SR group. CONCLUSION: Autologous FL for frontalis suspension remains an excellent choice for (and should be considered as useful surgical armamentarium for) repair of severe congenital ptosis.