Silicone sling allows adjustable ptosis correction in children and in adults at risk of corneal exposure.

Background/aim: Brow suspension is the procedure of choice for ptosis correction in patients with poor levator function. A subgroup of these patients, namely the ocular myopathies, is at risk of progressive muscle weakness and subsequent corneal exposure. We aim to demonstrate that silicone rods can be easily adjusted and therefore allows greater control of lid height in these patients.

Method: A retrospective review of 42 consecutive silicone sling brow suspensions in 26 patients performed in Salisbury District Hospital between 1998 and 2007. The recurrence rate and ease of adjustment after silicone slings are compared with published results using monofilament prolene, polyfilament nylon, Mersilene mesh and expanded polytetrafluoroethylene.

Results: Children: 12 lids of 10 children had primary brow suspension using silicone slings. Median follow up was 42 months. One lid required adjustment 3.75 years after surgery. Adults: 30 lids of 16 patients had silicone sling brow suspensions. Median follow up was 22 months. Seven lids (19.4%) needed adjustment between 2 and 11 months after surgery (median 8 months).

Conclusion: Our results were comparable to alternative materials in respect of recurrence and were superior in respect of both granuloma formation and infection. Silicone is superior to all listed materials in respect of ease of adjustment of the sling in cases where the ideal lid position was not achieved after primary surgery.