Clinical Ophthalmology (Feb 2022)
The Combined Use of Silicone and Green Braided Polyester ‎Suture (Ethibond) versus ‎Silicone or Ethibond Alone for Frontalis ‎Suspension Surgery in Children
Abstract
Hala K Mattout, Sameh M Fouda, Sahar Hemeda Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Hala K Mattout, Email [email protected]; [email protected]: This study aimed to report the outcomes of correcting severe congenital blepharoptosis by frontalis suspension using combined silicone tube and 2– 0 green braided polyester suture (Ethibond), and to compare the results with those of silicone rod alone and Ethibond suture alone.Patients and Methods: The medical records of patients below 16 years who underwent frontalis suspension were retrospectively reviewed. Three groups of patients were identified; group I (16 patients: 22 eyelids) had frontalis suspension surgery using silicone suspension set, group II (18 patients: 25 eyelids) underwent the surgery using Ethibond suture, and group III (15 patients: 23 eyelids) was operated on using combined silicone and Ethibond suture. The primary outcome measures were postoperative marginal reflex distance-1 (MRD-1) and postoperative symmetry, and the secondary outcome measures were the occurrence of complications; mainly recurrence and wound-related complications. The follow-up data were collected after 1 week, 1 month, 6 months, 12 months and every 6 months thereafter.Results: The follow-up period ranged from 18 to 36 months. By the last follow-up visit, 13 eyelids in silicone group (59%), 11 eyelids in the Ethibond group (44%), and 13 eyelids in the double sling group (57%) achieved good surgical correction with MRD1 ≥ 3mm; these differences were not statistically significant. The difference in symmetry among the three groups was not significant. The highest rates of recurrence (44%) and wound-related problems (8%) were encountered in the Ethibond group, while the silicone group had no cases of wound-related problems. The lowest recurrence rate (26.1%) was in the double sling group but those differences were not significant.Conclusion: Combined use of silicone and Ethibond suture in frontalis suspension surgery could offer lower recurrence rate and good final surgical outcome when compared to silicone rod or Ethibond suture alone.Keywords: Ethibond, silicone tube, double sling, frontalis suspension, ptosis
