Abstract Listings 2024

Purpose

Frontalis suspension surgery (FSS) involves suspending the upper lid to the frontalis muscle using materials such as autogenous fascia lata or synthetic materials. Due to the risks of foreign body reaction, infection, and extrusion in synthetic materials, fascia lata (FL) is widely preferred. However, harvesting autologous FL has significant disadvantages, including potential donor site morbidity, longer surgical time, the necessity for general anesthesia, and unavailability for patients under three years of age. Allogenic FL is an alternative material that avoids these issues. However, reports on surgical outcomes have been mixed, with high long-term revision rates. This retrospective study describes our experience with FESS using preserved dehydrated Tutoplast® FL, a commercially available allograft.

Methods

All patients with ptosis who underwent FSS with Tutoplast® FL between 2010 and 2023 at the University Eye Hospital Essen were identified. Data were obtained from clinical examination records and surgical protocols. The main assessment criteria were measurements of palpebral fissure height (PFH) before and after FSS, the occurrence of surgical complications, and the need for long-term revisions.

Results

A total of 117 eyes from 87 patients underwent FSS using Tutoplast®. Of these, 24.1% (n=21) had previous ptosis surgeries, 75.9% were operated on for the first time. The mean age was 33.2 years, ranging from 6 months to 87 years. The mean preoperative PFH was 3.5 mm, increasing to a mean postoperative PFH of 6.7 mm. The follow-up period averaged 1 year, with a maximum of 12 years. One eye required revision by sling tightening after 2 days due to insufficient lid height. Eight eyes (6.8%) underwent re-operation after a mean of 37.25 months (range 6-86 months). Post-surgical complications were recorded in 8 of the 126 surgeries (6.3%), mainly presenting as redness and swelling.

Conclusion

In our experience FSS using Tutoplast® FL effectively increases PFH with a low complication rate and low revision rate. It offers a viable alternative to autologous FL, reducing associated morbidity and surgical complexity.

Additional Authors

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