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Children with severe, unilateral congenital ptosis are at risk of developing amblyopia if the lid obscures the visual axis. In this situation, urgent repair of the ptosis is indicated. These patients generally have very poor function of the levator palpebrae superioris muscle and a brow suspension is required. The suspensory material which gives the best long-term results is autogenous fascia lata. In young children, however, there is insufficient autogenous fascia available. We reviewed 9 patients aged 4 years or less who had undergone surgery for congenital ptosis. In each case a brow suspension was performed using 4/0 Prolene (monofilament polypropylene) suture as a temporary suspensory material. All patients achieved a satisfactory result with the upper lid remaining clear of the visual axis during a mean follow-up period of 18.7 months (range 8-29 months). We suggest that Prolene suture is a readily available material which is suitable as a temporary suspensory material for brow suspension in very young children.

The use of prolene as a temporary suspensory material for brow suspension in young children