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Frontalis sling surgery: do we really need the Wright needle?

Suspensão ao músculo frontal: realmente precisamos da agulha de Wright?

ABSTRACT

Purpose:

The aim of this study is to describe a variation in technique of the frontalis sling surgery with silicone rods and its results, using an alternative needle with similar effectiveness to the Wright needle at a reduced cost.

Methods:

This was a prospective, interventional, noncomparative study of patients with severe ptosis who underwent surgical correction using a simple and modified frontalis sling surgery technique. Patients were included in this study from January 2012 to January 2014. 23 surgeries were performed on 15 patients. The minimum "follow-up" was 12 months.

Results:

Most patients had congenital ptosis (86%) and the average preoperative margin reflex distance 1 (MRD1) was -1.1 mm (range -3 to 0 mm). 1 week post-operation, this was 2.7 mm ( 1.8 to 3.8 mm), 1.8 mm after 1 month and 1.7 mm (1 to 2.5 mm) after one year. The satisfaction rate was 80% (12 patients). Among the dissatisfied patients, one had extrusion and infection with subsequent explantation of the wire, one had asymmetry greater than 2 mm and one had persistent lagophthalmos and punctate keratitis, with subsequent explantation of silicone.

Conclusion:

The use of silicone rods with tarsal fixation using an alternative needle was effective in the treatment of severe ptosis with few complication rates, a low rate of dissatisfaction and good stability of the results in the follow-up period.

Keywords:
Blepharoptosis/surgery; Frontalis sling/surgery; Eyelids/surgery; Ptosis/congenital; Treatment outcome

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