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Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis

Background Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with rec... Full description

Journal Title: PLoS ONE 2017, Vol.12(2)
Main Author: Kim, Chang Yeom
Other Authors: Son, Byeong Jae , Son, Jangyup , Hong, Jongill , Lee, Sang Yeul
Format: Electronic Article Electronic Article
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ID: E-ISSN: 1932-6203 ; DOI: 10.1371/journal.pone.0171769 ; PMCID: 5313185 ; PMID: 28207846
Link: pone.0171769.pdf
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title: Analysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis
format: Article
creator:
  • Kim, Chang Yeom
  • Son, Byeong Jae
  • Son, Jangyup
  • Hong, Jongill
  • Lee, Sang Yeul
subjects:
  • Research Article
  • Physical Sciences
  • Medicine And Health Sciences
  • Biology And Life Sciences
  • Medicine And Health Sciences
  • Medicine And Health Sciences
  • Biology And Life Sciences
  • Medicine And Health Sciences
  • Biology And Life Sciences
  • Medicine And Health Sciences
  • Physical Sciences
  • Physical Sciences
  • Medicine And Health Sciences
  • Physical Sciences
  • Physical Sciences
ispartof: PLoS ONE, 2017, Vol.12(2)
description: Background Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. Methods This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. Results Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. Conclusions Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics.
language:
source:
identifier: E-ISSN: 1932-6203 ; DOI: 10.1371/journal.pone.0171769 ; PMCID: 5313185 ; PMID: 28207846
fulltext: fulltext
issn:
  • 1932-6203
  • 19326203
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titleAnalysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis
creatorKim, Chang Yeom ; Son, Byeong Jae ; Son, Jangyup ; Hong, Jongill ; Lee, Sang Yeul
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descriptionBackground Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. Methods This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. Results Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. Conclusions Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics.
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titleAnalysis of the causes of recurrence after frontalis suspension using silicone rods for congenital ptosis
descriptionBackground Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. Methods This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. Results Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. Conclusions Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics.
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abstractBackground Silicone rod is a commonly used synthetic suspension material in frontalis suspension surgery to correct blepharoptosis. The most challenging problem and a decisive drawback of the use of silicone rod is a considerable rate of ptosis recurrence after surgery. We examined patients with recurred ptosis and assessed the physical and micromorphological properties of implanted silicone rods to determine the causative mechanisms of recurred ptosis after frontalis suspension using silicone rod. Methods This is a prospective observational case series of 22 pediatric patients with recurred ptosis after frontalis suspension using silicone rods for congenital ptosis. Implanted silicone rods were observed and removed during the operation for correction of recurred ptosis. The removed silicone rods were physically and micromorphologically evaluated to determine the cause of recurrence. Results Pretarsal fixation positions migrated upward, whereas suprabrow fixation positions migrated downward during ptosis recurrence. The breaking strength of implanted silicone rods was reduced by approximately 50% during 3 years. Cracks, debris, and loss of homogenous structure with disintegration were observed on scanning electron micrographs of implanted silicone rods in patients with recurred ptosis. Preoperative severe degree of ptosis also contributed to recurred ptosis. Conclusions Recurrence of ptosis after frontalis suspension using silicone rod was associated with physical changes of implanted silicone rods, including positional migration, weakened tensile strength, and micromorphological changes in combination with patients’ characteristics.
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doi10.1371/journal.pone.0171769
pmid28207846
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date2017-02-16