{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:38:15Z","timestamp":1790285895375,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Frontalis suspension (FS) is the treatment of choice in congenital ptosis with poor levator function. We report the surgical outcome of FS using a double triangle configuration of silicone slings in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of all paediatric patients with simple myogenic congenital ptosis repaired with FS over a 12\u2010year period (2009\u20132020). Each silicone sling was secured by simple knots. Pre\u2010 and post\u2010operative margin reflex distance (MRD<jats:sub>1<\/jats:sub>) measurements were determined from clinical photographs using ImageJ Software. Main outcome measures were improvement in eyelid height, eyelid asymmetry, reoperation rate and timing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and thirty nine patients (174 eyes) were included, with 35 (25%) having bilateral surgery. Mean (\u00b1SD) age was 1.4\u2009\u00b1\u20091.9\u2009years. Mean follow up time was 32\u2009\u00b1\u200920.5\u00a0months. Sixteen patients (11%) had a history of previous ptosis repair surgery. Mean MRD<jats:sub>1<\/jats:sub> improved by an average of 1.5\u2009mm. The final MRD<jats:sub>1<\/jats:sub> in the group of patients who did not have a second procedure was a mean of 2.1\u2009mm. The MRD<jats:sub>1<\/jats:sub> difference between both eyes in all unilateral cases improved from 2.5\u2009mm preoperatively to 1.2\u2009mm at final visit (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the 123 cases without a history of previous ptosis surgery, repeat ptosis repair was performed in 37 (30%) patients, 34.9\u2009\u00b1 19.9\u00a0months after the initial procedure. Overall, repeat repair was performed in 47 patients (34%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Double triangle silicone sling frontalis suspension has a favourable outcome in two\u2010thirds of paediatric patients with simple myogenic congenital ptosis. Failed cases can be addressed with a second repair, using either autogenous fascia lata or a second silicone sling.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.14112","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T05:06:02Z","timestamp":1653455162000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Silicone sling frontalis suspension for congenital ptosis: Outcome of 174 consecutive cases"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0910-3829","authenticated-orcid":false,"given":"Daphna","family":"Landau Prat","sequence":"first","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"},{"name":"The Sheba Talpiot Medical Leadership Program, Division of Ophthalmology, The Goldschleger Eye Institute Sheba Medical Center  Tel Hashomer Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Revere","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Katowitz","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Katowitz","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine The University of Pennsylvania  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-60814-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.05.031"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000001697"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1979.01020020227009"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(66)91334-1"},{"issue":"3","key":"e_1_2_7_7_1","first-page":"129","article-title":"Evaluation of expanded polytetrafluoroethylene (e\u2010PTFE) and autogenous fascia lata in frontalis suspension. 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