Outcome of frontalis suspension surgery in pediatric ptosis

Purpose: To describe the outcome of pediatric ptosis surgery using frontalis suspension technique. Design: Retrospective study. Methods: All patients with ptosis who underwent frontalis suspension from April 2009 to April 2014 at the Children’s Hospital at Westmead were included. Medical records of patients were reviewed and analyzed. Results: A total of 55 patients (74 primary procedures) were included in the study. Sixty-eight procedures (91.9%) used silicone as frontalis suspension material, three procedures used Gore-Tex, and three procedures used fascia lata. For procedures using silicone, the recurrence rate was 10.29%; 4.41% had infection and 1.47% had exposure keratopathy. All three procedures using Gore-Tex developed postoperative infection. No postoperative complication was documented in all the three procedures using fascia lata. Conclusion: A change in the practice from using banked fascia lata to silicone as frontalis suspension material is seen at the Children’s Hospital at Westmead. The postoperative complications and recurrence rate in procedures using silicone are relatively low. Autologous fascia lata could be considered as an alternative for older children in view of its long-term success rate and fewer complications.