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Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis
BACKGROUND: Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with re...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313185/ https://www.ncbi.nlm.nih.gov/pubmed/28207846 http://dx.doi.org/10.1371/journal.pone.0171769 |
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author | Kim, Chang Yeom Son, Byeong Jae Son, Jangyup Hong, Jongill Lee, Sang Yeul |
author_facet | Kim, Chang Yeom Son, Byeong Jae Son, Jangyup Hong, Jongill Lee, Sang Yeul |
author_sort | Kim, Chang Yeom |
collection | PubMed |
description | BACKGROUND: Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. METHODS: This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. RESULTS: Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. CONCLUSIONS: Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics. |
format | Online Article Text |
id | pubmed-5313185 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53131852017-03-03 Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis Kim, Chang Yeom Son, Byeong Jae Son, Jangyup Hong, Jongill Lee, Sang Yeul PLoS One Research Article BACKGROUND: Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. METHODS: This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. RESULTS: Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. CONCLUSIONS: Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics. Public Library of Science 2017-02-16 /pmc/articles/PMC5313185/ /pubmed/28207846 http://dx.doi.org/10.1371/journal.pone.0171769 Text en © 2017 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kim, Chang Yeom Son, Byeong Jae Son, Jangyup Hong, Jongill Lee, Sang Yeul Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title | Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title_full | Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title_fullStr | Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title_full_unstemmed | Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title_short | Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
title_sort | analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313185/ https://www.ncbi.nlm.nih.gov/pubmed/28207846 http://dx.doi.org/10.1371/journal.pone.0171769 |
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