Frontalis suspension is the surgery of choice for congenital or acquired blepharoptosis with poor levator function (less than 5 mm). This procedure can be performed unilaterally or bilaterally in both children and adults. A variety of materials have been used with varying success. The ideal material is readily available, inert, adjustable, and has good, long-lasting tensile strength. Autologous materials frequently include fascia lata, temporalis fascia, and palmaris longus tendon. Allograft materials include mainly preserved fascia lata. Synthetic materials used for frontalis suspension include monofilament nylon, polypropylene, polybutylate-coated braided polyester, polyfilament cable-type suture, polyester fiber, expanded polytetrafluoroethylene (ePTFE), and silicone. Each of these materials has its own advantages and disadvantages. Adjustable sling materials may have specific advantages in patients with progressive ptosis or who are at risk for corneal decompensation. Excellent functional and aesthetic results can be obtained with frontalis slings when carefully placed with attention to surgical detail in all age groups.
Fascia Lata Frontalis Muscle Frontalis Suspension Chronic Progressive External Ophthalmoplegia Palmaris Longus Tendon
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Jordan DR, Anderson RL. Obtaining fascia lata. Arch Ophthamol. 1987;105:1139–40.Google Scholar
Naugle Jr TC, Fry CL, Sabatier RE, Elliott LF. High leg incision fascia lata harvesting. Ophthalmology. 1997;104(9):1480–8.PubMedGoogle Scholar
Malhotra R, Selva D, Olver JM. Endoscopic harvesting of autogenous fascia lata. Ophthal Plast Reconstr Surg. 2007;23(5):372–75.CrossRefPubMedGoogle Scholar
Tellioglu AT, Saray A, Ergin A. Frontalis sling operation with deep temporal fascial graft in blepharoptosis repair. Plast Reconstr Surg. 2002;109(1):243–8.CrossRefPubMedGoogle Scholar
Wong CY, Fan DSP, Ng JS, Goh TY, Lam DS. Long-term results of autogenous palmaris longus frontalis sling in children with congenital ptosis. Eye. 2005;19:546–8.CrossRefPubMedGoogle Scholar
Lam DS, JS Ng, Cheng GP, Li RT. Autogenous palmaris longus tendon as frontalis suspension material for ptosis correction in children. Am J Ophthalmol. 1998;126:109–15.CrossRefPubMedGoogle Scholar
Medel R, Alonso T, Giralt J, Torres J, González-Candial M, García-Arumí J. Frontalis muscle flap advancement with a pulley in the levator aponeurosis in patients with complete ptosis and deep-set eyes. Ophthal Plast Reconstr Surg. 2006;22(6):441–4.CrossRefPubMedGoogle Scholar
Broughton WL, Matthews II JG, Harris Jr DJ. Congenital ptosis. Results of treatment using lyophilized fascia lata for frontalis suspensions. Ophthalmology. 1982;89(11):1261–6.PubMedGoogle Scholar
Wilson ME, Johnson RW. Congenital ptosis; long term results of treatment using lyophilized fascia lata for frontalis suspension. Ophthalmology. 1991;98:1234–37.PubMedGoogle Scholar
Esmaeli B, Chung H, Pashby RC. Long-term results of frontalis suspension using irradiated, banked fascia lata. Ophthal Plast Reconstr Surg. 1998;14(3):159–63.CrossRefPubMedGoogle Scholar