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Ferrara M., Strianese D., Carandente R., Iuliano A., Bonavolontà G.
Dipartimento di Scienze Oftalmologiche Università degli Studi di Napoli “Federico II” Napoli, Italia
Aim: The purpose of this study was to evaluate the results of silicone rod frontalis suspension for correction of myogenic blepharoptosis with poor or absent levator function in adult patients.
Methods: In this retrospective study we examined a cohort of 24 eyelids of 13 patients underwent doubled silicone rod frontalis suspension from January 1997 to June 2011. Preoperative diagnoses included ptosis associated with Steinert Myotonic Dystrophy, Myasthenia Gravis, Chronic Progressive External Ophthalmoplegia and OculoPharyngeal Muscular Dystrophy. The criteria used to evaluate functional success were: a) satisfactory lid height (defined as margin-to-reflex distance ≥3 mm); b) satisfactory lid symmetry (≤2 mm asymmetry in margin-to-reflex distance); c) satisfactory cosmesis.
Results: The mean follow-up time was 91 months (7,6 years), ranged from 19 to 196 months. Functional success rate was 83% (20/24 eyelids). The reported complications were: exposure keratopathy in 11 eyes (46%) which resolved with lubrificants, recurrent exposure keratopathy in both eyes of one patient (8%) and ptosis recurrence in 2 eyelids (8%).
Conclusion: Silicone rod is low cost material, easily adjustable and well tolerated. Doubled silicone rod frontalis suspension may be considered an effective procedure for correction of severe ptosis with poor or absent levator function and poor or absent Bell phenomenon in patients affected by non-congenital ptosis.