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PURPOSE: To develop an automated, new framework based on machine learning to diagnose malignant eyelid skin tumors. METHODS: This study used eyelid lesion images from Sheba Medical Center, a large tertiary center in Israel. Before model training, we pretrained our models on the International Skin Imaging Collaboration (ISIC) 2019 dataset consisting of 25,332 images. The proprietary eyelid data set was then used for fine-tuning. The data set contained multiple images per patient, aiming to classify malignant lesions in comparison to benign counterparts. RESULTS: The analyzed data set consisted of images representing both benign and malignant eyelid lesions. For the benign category, a total of 373 images were sourced. By comparison, for the malignant category, 186 images were sourced. For the final model, at sensitivity of 93.8% (95% CI 80.0-100.0%), the model has a corresponding specificity of 73.7% (95% CI 60.0-87.1%). To further understand the decision-making process of our model, we employed heatmap visualization techniques, specifically gradient-weighted Class Activation Mapping. DISCUSSION: This study introduces a dependable model-aided diagnostic technology for assessing eyelid skin lesions. The model demonstrated accuracy comparable to human evaluation, effectively determining whether a lesion raises a high suspicion of malignancy or is benign. Such a model has the potential to alleviate the burden on the health care system, particularly benefiting rural areas, and enhancing the efficiency of clinicians and overall health care.
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INTRODUCTION: Retinal detachment is visually impairing in children and adults. The treatment for retinal detachment is challenging, especially in children. There are many etiologies for retinal detachment such as retinal detachment due to retinal tear (rhegmatogenous), tractional retinal detachment and exudative detachment. It is crucial to understand retinal detachment etiology in the pediatric population as it affects treatment decisions. After the diagnosis of retinal detachment in a child, and its etiology, a long process of surgical treatment and recovery begins. The process may include more than one surgery, and therefore close follow-up is very important. Even with anatomic success, functional results are worse with children. The purpose of this article is to review the common etiologies for retinal detachment in children and present case studies that were treated in our department.
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Descolamento Retiniano , Criança , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Acuidade VisualRESUMO
PURPOSE: Clinical outcome and switch patterns with bevacizumab first treatment strategy for patients with newly diagnosed neovascular age-related macular degeneration (nAMD). METHODS: Retrospective observational study of the number of intravitreal injections of bevacizumab and treatment switch in patients who started intravitreal bevacizumab injections between January 1, 2016 and December 30, 2018. RESULTS: From January 1 2016 to December 31 2018, 608 eyes of 565 patients started intravitreal injections of bevacizumab for a new diagnosis of nAMD. Average visual acuity (VA) at presentation was 0.60 logarithm of the minimum angle of resolution (logMAR), which improved to 0.47 after six injections (P < 0.001) and decreased to 0.63 at the last follow-up (P = 0.543). Switch of treatment was recommended for 190 eyes (31.3%), and of them, 91 patients (15%) were switched during the first 6 months and defined as primary failure of bevacizumab. The switch of treatment resulted in a statistically significant improvement in VA in the first 6 months after the switch. The gain in VA was not sustainable over time. CONCLUSION: Bevacizumab first treatment strategy produced results that were comparable to previous real-world outcomes publications of ranibizumab and aflibercept treatment with low rates of failure of bevacizumab treatment. Treatment switch to second-line treatment yielded a significant VA improvement, mainly in patients with primary bevacizumab failure.
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Diabetes Mellitus , Retinopatia Diabética , Edema Macular , Humanos , Bevacizumab , Edema Macular/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/tratamento farmacológico , Inibidores da Angiogênese , Receptores de Fatores de Crescimento do Endotélio Vascular , Ranibizumab , Proteínas Recombinantes de Fusão/uso terapêutico , Injeções Intravítreas , Estudos RetrospectivosRESUMO
OBJECTIVE: To describe the risk and nature of retinopathy of prematurity (ROP) in micro-premature infants (≤26 weeks' gestational age [GA]). METHODS: Retrospective analysis of prospectively collected data from infants born at 22-26 weeks' GA over a 5-year period. RESULTS: A total of 502 infants were identified, of whom 414 survived to discharge (82.5%). The Vermont Oxford Network database documented clinical follow-up data and ROP outcomes for all 414 patients; complete ROP clinical records were available for 294 of the infants who survived (70.8%). Forty infants were born between 22 and 23 weeks' GA (group A, 13.6%), and 254 were born between 24 and 26 weeks' GA (group B, 86.4%). Survival for group A infants was worse than that of group B infants (66.2% vs 85.4%; p < 0.01). Survival of group A infants improved during the study period (R2â¯=â¯0.625). Overall, 59.9% of infants developed any ROP and 8.5% developed type 1 ROP. Group A infants were more likely to develop ROP (90.0% vs 48.6%; p < 0.01) and type 1 ROP (30.0% vs 5.1%; p < 0.01) than group B infants. Group A infants developed ROP at an earlier age (32â¯+â¯6 weeks vs 33â¯+â¯3 weeks; pâ¯=â¯0.02) and were more likely to have zone I disease on presentation (65.0% vs 20.5%; p < 0.01), but there was no difference in the corrected gestational age of peak severity of ROP (35â¯+â¯2 weeks vs 34â¯+â¯5 weeks; pâ¯=â¯0.36). CONCLUSION: The most premature infants, born at 22-23 weeks' GA, develop ROP at an earlier age, are more likely to present with posterior disease, and have a high risk of disease requiring treatment.
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PURPOSE: To describe our experience using short-term heavy silicone oil (Densiron 68) for macula-on inferior rhegmatogenous retinal detachments with inferior retinal breaks. METHODS: Retrospective, consecutive, observational case series. Data were retrospectively collected from the medical records of patients who underwent pars plana vitrectomy and Densiron 68 endotamponade for macula-on rhegmatogenous retinal detachment repair. RESULTS: Eight patients were included in the study. The mean patient age was 57.1 ± 12.3 (±SD) years. The mean time to Densiron 68 removal was 57.8 ± 17.8 (±SD) days (ranging from 24 to 83 days). One patient (12.5%) detached three weeks after Densiron 68 removal and required further surgery. All patients were attached at last follow-up with a mean follow-up of 192 days. The mean final best-corrected visual acuity was 20 of 40 (0.29 logarithm of the minimum angle of resolution) similar to the 20 of 45 preoperative best-corrected visual acuity (0.35 logarithm of the minimum angle of resolution, P = 0.501). No significant emulsification was noted before or during the removal of the Densiron 68. Two patients developed an increase in intraocular pressure before Densiron 68 removal that resolved after removal. One patient developed cystoid macular edema that resolved with a short course of topical medications, and one patient had persistent CME that required an intravitreal triamcinolone acetate 1% injection. CONCLUSION: The high anatomic success rate, good visual outcomes, and minimal complications suggest that Densiron 68 can be considered as a short-term tamponade for macula-on retinal detachments with inferior pathology.
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Descolamento Retiniano , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Óleos de Silicone/efeitos adversos , Resultado do Tratamento , Acuidade Visual , Vitrectomia/efeitos adversosRESUMO
PURPOSE: To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair. DESIGN: Retrospective, consecutive, observational case series. METHODS: Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina. RESULTS: In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA. CONCLUSIONS: Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.
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Membrana Epirretiniana , Macula Lutea , Descolamento Retiniano , Perfurações Retinianas , Membrana Epirretiniana/patologia , Membrana Epirretiniana/cirurgia , Humanos , Macula Lutea/patologia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/patologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Vitrectomia/métodosRESUMO
BACKGROUND: To evaluate the effect of short-term Densiron tamponade on macular thickness. METHODS: Retrospective case series. Data were collected from charts of patients who received short-term (less than 90 days) Densiron tamponade. The OCT parameters were compared between Densiron in situ and after Densiron removal and to the fellow eye. RESULTS: Twenty eyes were included in the analysis. Although there was a trend toward thinner CRT with Densiron in situ in situ the operated eye when compared to the fellow eye (248 and 264 microns, respectively, p = .066), this difference disappeared after DR. At the final OCT there was a statistically significant recovery in the CRT (from 248 to 277 microns, P = .001) and no statistical difference between operated and the fellow eye (p = .265) with no evidence of ERM or CME. CONCLUSIONS: We found transient macular thinning that resolved after Densiron removal with no evidence of long-term macular thinning in eyes treated with Densiron tamponade for retinal detachment.
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Tamponamento Interno/métodos , Macula Lutea/diagnóstico por imagem , Descolamento Retiniano/cirurgia , Óleos de Silicone/farmacologia , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/diagnóstico , Estudos RetrospectivosRESUMO
PURPOSE: To describe and evaluate the clinical outcomes of the Flanged Prolene Suture intraocular lens fixation (PIF) technique and compare it to anterior chamber IOL (ACIOL) implantation. DESIGN: A retrospective comparative review. METHODS: A retrospective comparative review of consecutive patients undergoing secondary IOL implantation was performed. A comparison between patients that had ACIOL and PIF technique was conducted. The main outcome measures were changes in best-corrected visual acuity (VA), IOL position and complications. RESULTS: In the study period, fourteen eyes had ACIOL implantation and ten eyes had PIF surgery. VA acuity for both groups combined improved from 1.27 ± 0.65 logMAR preoperatively to 0.84 ± 0.65 logMAR (P<0.0001). Seventeen patients had VA measurements in the year before the IOL dislocation. In those seventeen patients, VA changed from a baseline of 0.90 ± 0.68 to 0.97 ± 0.61 logMAR in the PIF group (p=0.334) and from 0.54 ± 0.27 to 0.85 ± 0.65 logMAR in the ACIOL group (p=0.145). No intraoperative or early postoperative complications were documented in either group. Two (20%) patients in the PIF group developed CME and one patient developed corneal edema. In the ACIOL group, one patient developed significant CME and two patients developed visual significant corneal edema. CONCLUSION: The PIF technique seems to offer a simple, fast and safe way to fixate an IOL posteriorly. In our experience, the learning curve of the technique is short with a low complication rate and good visual outcomes.
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PURPOSE: To demonstrate the relationship between an intraocular gas bubble, the retina, and the residual intraocular fluid in different head positions using orbital magnetic resonance imaging (MRI) in 3 patients who underwent pars plana vitrectomy (PPV) with gas tamponade. DESIGN: Novel study. PARTICIPANTS: Patients undergoing PPV with gas-fluid exchange (sulfurhexafluoride [SF6] or perfluoropropane [C3F8]). METHODS: Magnetic resonance imaging scans were obtained in 3 patients undergoing PPV with gas-fluid exchange (SF6 or C3F8). All surgeries were performed by a single surgeon (E.D.M.). On the first postoperative day, the volume of intraocular gas fill was estimated separately by 2 surgeons (A.H. and E.D.M). Four orbital MRI scans were obtained from different head positions, including face up (supine), face down (prone on a massage pillow), flat on the right side, and flat on the left side. MAIN OUTCOME MEASURE: Relationship between the gas bubble and residual vitreous fluid. RESULTS: The MRI images demonstrated, with excellent contrast, the gas and fluid locations in the vitreous cavity in all scans. The relationship between the gas bubble and residual vitreous fluid showed a rapid shift when the patient's head position changed. The MRI images demonstrated that with both 70% gas fill and 95% gas fill, lying on the side can give better support to the inferior retina than face-down positioning. The images demonstrated the importance of accurate head positioning, because a slight change in head position resulted in inadequate contact between the anterior inferior retina and the gas bubble. CONCLUSIONS: To our knowledge, this is the first time that the relationship between an intraocular gas bubble and contact with the retina has been evaluated in different head positions in vivo using MRI imaging. The MRI images demonstrated that side positioning gives better contact between the gas bubble and the inferior and anterior retina than prone positioning even when the gas fill is only 70% of the vitreous cavity.
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Tamponamento Interno/métodos , Imageamento por Ressonância Magnética/métodos , Órbita/patologia , Posicionamento do Paciente/métodos , Perfurações Retinianas/cirurgia , Acuidade Visual , Vitrectomia/métodos , Idoso , Humanos , Pessoa de Meia-Idade , Retina/patologia , Retina/cirurgia , Perfurações Retinianas/diagnóstico , Estudos RetrospectivosRESUMO
Objective: To study the effectiveness and safety of the intravitreal dexamethasone implant 0.7 mg (Ozurdex®) in vitrectomy surgery for epiretinal membrane.Methods: This is a prospective, multicenter, pilot study. Inclusion criteria included visually significant (<20/50) idiopathic epiretinal membrane. All patients underwent 23-gauge pars plana vitrectomy with membrane peeling and Ozurdex implant injection. The primary outcome measure was best corrected visual acuity (BCVA) change at 3 months. Secondary outcomes included BCVA at 6 months and changes in central retinal thickness (CRT). Intraocular (IOP) changes were monitored and cataract progression in phakic patients was documented.Results: 15 patients were enrolled in the study, 12 eyes of 12 patients were included in the analysis. Mean preoperative BCVA was 50.67 ETDRS letters and improved significantly to 63.67 (+12.91 letters, p = .008) at 3 months. Mean CRT improved from 548 to 409 microns (p = .002) at 3 months. The IOP showed mild elevation at months 1 and 2 and returned almost to baseline at month six. There were no complications related to the steroid implant injection procedure in an air-filled eye.Conclusions: Intra-operative injection of Ozurdex® at the conclusion of PPV can be done safely. The peak IOP and lowest CRT after 2 months strengthens the findings of prior studies demonstrating Ozurdex activity up to 3 months in vitrectomized eyes.
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Dexametasona/administração & dosagem , Membrana Epirretiniana/cirurgia , Glucocorticoides/administração & dosagem , Vitrectomia , Idoso , Idoso de 80 Anos ou mais , Implantes de Medicamento , Membrana Epirretiniana/fisiopatologia , Feminino , Humanos , Período Intraoperatório , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Retina/patologia , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To determine the effect of topical brimonidine tartrate prophylaxis on intraocular pressure (IOP) spikes following intravitreal injection of antivascular endothelial growth factor (anti-VEGF) agents. METHODS: This is a randomised crossover trial of consecutive non-glaucomatous eyes receiving intravitreal anti-VEGF injections between December 2016 and July 2017. All eyes were randomly assigned to no prophylaxis or topical brimonidine tartrate 0.15 % administered 20 min prior to injection in one of two consecutive visits. Measurements of IOP were obtained immediately (T0), 10 min (T10) and 20 min (T20) after injection during the visits with and without prophylaxis. RESULTS: Among the 58 eyes of 55 patients (116 visits), the mean (SD) age was 74.3 (11.6), and 62% were female. The mean baseline IOP was 15.3 (2.3) mm Hg (range: 11-20). On average, the immediate postinjection IOP during the visit without prophylaxis was 41.6 (12) mm Hg (range: 17-81). Compared with no prophylaxis, the visit with preadministered topical brimonidine tartrate had a lower IOP at T0 (p<0.001), T10 (p=0.001) and T20 (p=0.043), and a smaller proportion of eyes with IOP elevation of greater than 20 mm Hg from preinjection (p=0.002) and IOP greater than 50 mm Hg at T0 (p=0.036). Without prophylaxis, two eyes (two patients) had an IOP of greater than 70 mm Hg at T0 and thus underwent anterior chamber paracentesis. CONCLUSION: Topical brimonidine tartrate prophylaxis for intravitreal injection of anti-VEGF agents effectively reduces IOP spikes in non-glaucomatous eyes and may be easily incorporated into ophthalmologists' current practice. TRIAL REGISTRATION NUMBER: NCT03513172.
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Inibidores da Angiogênese/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Tartarato de Brimonidina/uso terapêutico , Pressão Intraocular/efeitos dos fármacos , Hipertensão Ocular/prevenção & controle , Administração Oftálmica , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/efeitos adversos , Bevacizumab/uso terapêutico , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Injeções Intravítreas , Degeneração Macular/tratamento farmacológico , Edema Macular/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/induzido quimicamente , Soluções Oftálmicas , Estudos Prospectivos , Ranibizumab/efeitos adversos , Ranibizumab/uso terapêutico , Oclusão da Veia Retiniana/tratamento farmacológico , Tonometria Ocular , Resultado do TratamentoRESUMO
This study was to determine the prevalence of immunoglobulin G4 (IgG4)-related orbital disease (IgG4-ROD) among patients who have previously undergone biopsy and were diagnosed to have idiopathic orbital inflammatory disease (IOID) or orbital lymphoproliferative disease (OLD), namely, lymphoma and benign reactive lymphoid hyperplasia (BRLH). This is a retrospective cross-sectional study. The charts and slides of all patients who underwent biopsies and were histopathologically diagnosed to have either IOID or OLD were reviewed. Demographics, clinical features, initial histopathological diagnoses, treatment received, and final outcome were noted. Using the diagnostic criteria for diagnosis for IgG4 disease, those cases that would classify as "possible IgG4-related disease (IgG4-RD)" were reviewed, reclassified, and reassigned a diagnosis of IgG4-ROD. We reviewed 105 patients' clinical charts. Of these 105 patients, upon reviewing the histopathology, 18 (17.15%) patients were found to fit the diagnostic criteria for possible IgG4-ROD. Of these 18 patients who were now reassigned the diagnosis of IgG4-ROD, the most common previous histopathological diagnosis was found to be IOID, for eight patients (44%), then BRLH, which was noted in five patients (27.8%), followed by lymphoma, which was noted in two patients (11.1%). Previously diagnosed cases of IOID and OLD were found to fulfill the criteria for IgG4-ROD. Given the advent of recent diagnostic and histopathological techniques, all cases of suspected IOID and OLD should be screened for IgG4-ROD and all previously diagnosed cases must be closely followed up, given the systemic implication of IgG4-RD. Histopathological reassessment of previously diagnosed cases may be considered.
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Imunoglobulina G/sangue , Linfoma/diagnóstico , Neoplasias Orbitárias/diagnóstico , Pseudotumor Orbitário/diagnóstico , Pseudolinfoma/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Biópsia , Criança , Estudos Transversais , Feminino , Glucocorticoides/uso terapêutico , Humanos , Linfoma/epidemiologia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Orbitárias/epidemiologia , Neoplasias Orbitárias/terapia , Pseudotumor Orbitário/epidemiologia , Pseudotumor Orbitário/terapia , Plasmócitos/patologia , Prevalência , Pseudolinfoma/epidemiologia , Pseudolinfoma/terapia , Radioterapia , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
We studied the interaction of a single dose of different antidepressant medications with a single (acute) dose or implanted mini-pump (chronic) methadone administration in mice, using the hotplate assay. For the acute experiment, subthreshold doses of six antidepressant drugs were administered separately with a single dose of methadone. The addition of a subthreshold dose of desipramine or clomipramine to methadone produced significant augmentation of the methadone effect with each drug (p < 0.05). Fluvoxamine given at a fixed subthreshold dose induced a synergistic effect only with a low methadone dose. Escitalopram, reboxetine and venlafaxine given separately, each at a fixed subthreshold dose, induced no interaction. Possible clinical implications of these findings are that while escitalopram, reboxetine and venlafaxine do not affect methadone's antinociception in mice and are safe to be given together with methadone when indicated, fluvoxamine, clomipramine and desipramine considerably augment methadone-induced effects and should be avoided in this population due to the risk of inducing opiate overdose. For the chromic experiment, when a subthreshold dose of either escitalopram, desipramine or clomipramine was injected to mice following 2 weeks of methadone administration with the mini-pump, none of the antidepressant drugs strengthened methadone's analgesic effect. Further studies are needed before possible clinical implications can be drawn.
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Analgésicos Opioides/farmacologia , Antidepressivos de Segunda Geração/farmacologia , Metadona/farmacologia , Limiar da Dor/efeitos dos fármacos , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Animais , Citalopram/farmacologia , Clomipramina/farmacologia , Cicloexanóis/farmacologia , Desipramina/farmacologia , Interações Medicamentosas , Fluvoxamina/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos ICR , Morfolinas/farmacologia , Nociceptividade/efeitos dos fármacos , Reboxetina , Cloridrato de VenlafaxinaRESUMO
PURPOSE: To assess the use of a computerized program for evaluating the amount of trabecular meshwork (TM) pigmentation in normal (control), primary open-angle glaucoma (POAG), and pseudoexfoliation glaucoma/pigmentary dispersion glaucoma (PXFG/PDG) patients. METHODS: All included patients were from the Goldschleger Eye Institute glaucoma clinic. After signing an informed consent, each patient's anterior chamber angle was photographed using a single photo-slit under the same conditions. Only one eye per patient was photographed. The superior TM and the inferior TM were documented. Then, the degree of "blackness" (representing melanin pigment) was assessed using the ImageJ program. RESULTS: Of the 43 eyes photographed, 8 were excluded because of low-quality images. Of the remaining 35 patients, 14 were normal, 10 had POAG, and 11 had PXFG/PDG. The amount of pigment was the same in the control and the POAG patients whether the inferior TM (P=0.24), superior TM (P=0.58), or the sum inferior TM+superior TM (P=0.85) was measured. The pigment level was significantly higher in the PXFG/PDG group than in the control group (inferior TM, P<0.01; superior TM, P=0.047; sum, P<0.01). The difference between the inferior and the superior TM pigment levels was found to be statistically insignificant in all the groups (normal, P=0.86; POAG, P=0.10; PXFG/PDG, P=0.22). CONCLUSIONS: The use of ImageJ software might play a role in the quantification of pigment evaluation of the TM.
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Técnicas de Diagnóstico Oftalmológico , Glaucoma de Ângulo Aberto/metabolismo , Melaninas/metabolismo , Malha Trabecular/metabolismo , Idoso , Idoso de 80 Anos ou mais , Segmento Anterior do Olho , Feminino , Gonioscopia , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Projetos PilotoRESUMO
Frontalis suspension with the use of a silicone elastomer is one of the preferred procedures for correcting moderate-to-severe ptosis with poor levator function. This procedure involves the attachment of the upper eyelid to the frontalis muscle by a silicone sling. Although this surgery has been performed for many years, information regarding long-term outcomes and complications is relatively limited. We report a case of orbital inflammation 15 years after a frontalis silicone sling suspension operation for congenital ptosis.