Trapezoid-quadrilateral technique of frontalis suspension with synthetic material

OBJECTIVE: To describe a new method of frontalis suspension (FS) to prevent recurrences, undercorrection, and cosmetic problems, and to share our experiences in treatment of congenital ptosis using the trapezoid quadrilateral technique (TQT) and synthetic materials.

METHODS: Twenty-four eyes of 18 patients, admitted to Ankara Numune Training and Research Hospital 3rd Eye Clinic, Ankara, Turkey, between January 2002 to December 2004, were operated with a new method. All the patients had congenital ptosis, and they were 2-27 years old. Twelve of them were female and 6 of them were male. In this new method, the upper eyelid is fixed to the frontalis muscle from 2 points.

RESULTS: The visual axis was open, and there was good symmetry between both eyes at the end of a mean of 14 months follow-up. There was granuloma formation in both eyes of one patient, exposure keratopathy in both eyes of another patient, and recurrence of ptosis in one eye of one patient.

CONCLUSION: The TQT of FS with synthetic material does not cause any esthetic deformity and produces a balanced lifting in the upper eyelid. Therefore, we propose that it could be the preferred method in FS procedures performed with inorganic materials.