Abstract：
OBJECTIVE: To compare the outcome of silicone sling frontalis suspension (FS) surgery in children with simple congenital ptosis and children with complex ptosis.
METHODS: A retrospective cohort study.
METHODS: All pediatric patients who underwent silicone sling FS surgery between 2009 and 2020 at a single centre.
METHODS: Patients were divided based on etiology into simple congenital ptosis and complex congenital ptosis. Pre- and postoperative margin-to-reflex distance (MRD1) measurements were determined from clinical photographs. Main outcome measures were assessed as differences in improvement in eyelid height and reoperation rate between the groups.
RESULTS: Two-hundred and eight children were included: 139 simple and 69 complex cases, with 83 females (40%). Mean (±SD) age at intervention was 1.9 ± 2.9 years. Complex cases included blepharophimosis epicanthus inversus syndrome (n = 35), Marcus Gunn jaw-winking syndrome (n = 12), oculomotor palsy (n = 8), congenital fibrosis of extraocular muscles (n = 3), chronic progressive external ophthalmoplegia (n = 3), and others. Mean MRD1 improved by an average of 1.6 mm in both groups. Repeat ptosis correction was performed in 50 of 171 patients (29%) without a history of failed ptosis procedures, and this rate was similar between simple and complex cases. Children under 3 years of age had higher rates of repeat ptosis repair than older children (n = 59 of 175 [34%] vs n = 5 of 33 [15%]; p = 0.03, χ2 test).
CONCLUSIONS: Silicone sling FS has a favourable outcome in 70% of pediatric patients. Preoperative and final MRD1 and reoperation rates were similar between both groups, suggesting that despite the higher complexity in atypical cases, the outcome is similar.
METHODS: A retrospective cohort study.
METHODS: All pediatric patients who underwent silicone sling FS surgery between 2009 and 2020 at a single centre.
METHODS: Patients were divided based on etiology into simple congenital ptosis and complex congenital ptosis. Pre- and postoperative margin-to-reflex distance (MRD1) measurements were determined from clinical photographs. Main outcome measures were assessed as differences in improvement in eyelid height and reoperation rate between the groups.
RESULTS: Two-hundred and eight children were included: 139 simple and 69 complex cases, with 83 females (40%). Mean (±SD) age at intervention was 1.9 ± 2.9 years. Complex cases included blepharophimosis epicanthus inversus syndrome (n = 35), Marcus Gunn jaw-winking syndrome (n = 12), oculomotor palsy (n = 8), congenital fibrosis of extraocular muscles (n = 3), chronic progressive external ophthalmoplegia (n = 3), and others. Mean MRD1 improved by an average of 1.6 mm in both groups. Repeat ptosis correction was performed in 50 of 171 patients (29%) without a history of failed ptosis procedures, and this rate was similar between simple and complex cases. Children under 3 years of age had higher rates of repeat ptosis repair than older children (n = 59 of 175 [34%] vs n = 5 of 33 [15%]; p = 0.03, χ2 test).
CONCLUSIONS: Silicone sling FS has a favourable outcome in 70% of pediatric patients. Preoperative and final MRD1 and reoperation rates were similar between both groups, suggesting that despite the higher complexity in atypical cases, the outcome is similar.
摘要：
目的：比较硅胶吊带额叶悬吊术（FS）在儿童单纯性先天性上睑下垂和复杂上睑下垂患儿中的疗效。
方法：回顾性队列研究。
方法：所有在2009年至2020年期间在一个中心接受硅胶吊带FS手术的儿科患者。
方法：患者根据病因分为单纯性先天性上下垂和复杂性先天性上下垂。根据临床照片确定术前和术后边缘到反射距离（MR1）的测量值。主要结局指标被评估为两组之间眼睑高度改善和再手术率的差异。
结果：包括200名儿童：139例简单病例和69例复杂病例，女性83人（40%）。干预时的平均（±SD）年龄为1.9±2.9岁。复杂的病例包括内chan内翻综合征（n=35），MarcusGunn下颌眨眼综合征（n=12），动眼神经麻痹（n=8），先天性眼外肌纤维化（n=3），慢性进行性眼外肌麻痹（n=3），和其他人。两组的平均MRD1平均改善1.6mm。171例患者中有50例（29％）进行了重复下垂矫正，没有失败的下垂手术史。简单病例和复杂病例的比率相似。3岁以下儿童的重复下垂修复率高于年龄较大的儿童（175中的n=59[34％]，33中的n=5[15％]；p=0.03，χ2检验）。
结论：硅胶吊带FS在70％的儿科患者中具有良好的预后。两组术前和最终的MRD1和再手术率相似。这表明，尽管非典型病例的复杂性更高，结果是相似的。
方法：回顾性队列研究。
方法：所有在2009年至2020年期间在一个中心接受硅胶吊带FS手术的儿科患者。
方法：患者根据病因分为单纯性先天性上下垂和复杂性先天性上下垂。根据临床照片确定术前和术后边缘到反射距离（MR1）的测量值。主要结局指标被评估为两组之间眼睑高度改善和再手术率的差异。
结果：包括200名儿童：139例简单病例和69例复杂病例，女性83人（40%）。干预时的平均（±SD）年龄为1.9±2.9岁。复杂的病例包括内chan内翻综合征（n=35），MarcusGunn下颌眨眼综合征（n=12），动眼神经麻痹（n=8），先天性眼外肌纤维化（n=3），慢性进行性眼外肌麻痹（n=3），和其他人。两组的平均MRD1平均改善1.6mm。171例患者中有50例（29％）进行了重复下垂矫正，没有失败的下垂手术史。简单病例和复杂病例的比率相似。3岁以下儿童的重复下垂修复率高于年龄较大的儿童（175中的n=59[34％]，33中的n=5[15％]；p=0.03，χ2检验）。
结论：硅胶吊带FS在70％的儿科患者中具有良好的预后。两组术前和最终的MRD1和再手术率相似。这表明，尽管非典型病例的复杂性更高，结果是相似的。
