Management of severe congenital ptosis autogenous fascia lata brow suspension

ABSTRACT

To evaluate the functional and cosmetic outcome of brow suspension surgery for unilateral severe congenital ptosis using autogenous fascia lata frontalis sling. Three female and one male patients with severe congenital ptosis were operated for functional and cosmetic reasons. All patients underwent unilateral frontalis sling suspension surgery using autogenous fascia lata. Pre and postoperative photographs were taken. Post-operative lid level, lid contour, lid contact with globe, shape, size, bilateral palpebral fissure symmetry, ptosis recurrence and cosmetic appearance of leg scars were evaluated. Patient's sentiments about the outcome of surgery were also recorded. The age of patients ranged from 17 to 18 years and follow up ranged from 24 to 40 months. All patients achieved satisfactory functional and cosmetic results and expressed high level of satisfaction with surgical outcome. None of our patients had ptosis recurrence, sling extrusion, infection or granuloma formation. Leg scars too had good cosmetic appearance. One patient had a slight under correction of ptosis which was corrected next day morning Under local anaesthesia. Autogenous facia lata is the material of choice for permanent ptosis correction when brow suspension sling is required. It avoids the problems associated with both donor human tissues and synthetic materials such as granuloma extrusion, infection and late failure. Harvesting fascia lata causes no postoperative morbidity