Frontal suspension surgery for ptosis: A review of complications and a rare case of massive chemosis and corneal ulcer
Author: Éva Juhász
Base Hospital / Institution: Semmelweis University, Ophthalmology Department
ePoster presentation
Abstract ID: 25-550
Purpose
To review the complications associated with frontal suspension surgery for ptosis and present a rare case of extensive chemosis and corneal ulceration following the procedure.
Methods
A retrospective analysis was conducted on patients undergoing frontal suspension ptosis surgery focusing on postoperative complications. Additionally, a detailed case study is presented of a 42 year old patient who developed massive conjunctival chemosis and a central corneal ulcer within 48 hours of surgery.
Results
According to literature review silicone sling frontalis suspension is associated with granuloma formation in 4–31% of cases, sling extrusion in 3–5%, and exposure keratopathy in up to 26%, with corneal ulceration occurring in about 3%. Ptosis recurrence rates can range from 20% to 50%, depending on underlying conditions and follow-up duration. In this case, the patient exhibited rapid-onset conjunctival edema and corneal ulcer resulting in sudden loss of vision. The patient was unable to close the eyelids. In response, the silicone band was released to alleviate potential mechanical restriction. An orbital CT scan was performed to rule out compressive orbital syndrome which fortunately was not present. Full recovery was achieved after 6 weeks with residual corneal scarring.
Conclusion
While frontal suspension surgery is generally safe, clinicians should be aware of rare but vision-threatening complications. Prompt recognition and aggressive management of severe chemosis and corneal ulceration are crucial to preserving ocular integrity and function. This case underscores the need for careful postoperative monitoring, especially in patients with predisposing surface disease or poor lid closure.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Zoltán Zsolt | Nagy | Semmelweis University, Ophthalmology Department |
| Kitti | Kormányos | Semmelweis University, Ophthalmology Department |
| Olga | Lukáts | Semmelweis University, Ophthalmology Department |
