Study on Frontalis Suspension With Double-Stranded Expanded Polytetrafluoroethylene Suture for Treating Severe Congenital Ptosis in Children

Objective: To evaluate the clinical efficacy and complications of frontalis muscle suspension surgery using double-stranded expanded polytetrafluoroethylene (ePTFE) sutures in the treatment of severe congenital ptosis in children. Methods: A total of 118 children (133 eyes) aged 3–7 years with severe congenital ptosis diagnosed at the Ophthalmic Hospital of Xi’an Fourth Hospital between December 2022 and January 2024 were enrolled. All patients underwent double-stranded ePTFE suture frontalis muscle suspension surgery. During postoperative follow-up examinations, assessments were conducted on palpebral fissure height, MRD1, eyelid closure status, and upper eyelid lag. Postoperative complications and their corresponding management outcomes were systematically documented. Results: Friedman test analysis of pediatric severe congenital ptosis treated with double-stranded ePTFE suture surgery showed significant MRD1 differences across time points ( χ 2 =894.9, P <0.05). Post hoc analysis revealed no MRD1 variation between 6-month and 1-year follow-ups ( P >0.05), nor lagophthalmos differences between 3 and 6 months postoperatively ( P >0.05). Complications included mild keratitis (1 case/eye), early infection (2/2), suspensory material exposure (2/2), and trichiasis (2/2), all resolved conservatively or surgically. Conclusions: The double-stranded ePTFE suture frontalis muscle suspension surgery demonstrates simplicity of operation, minimal trauma, rapid recovery, satisfactory postoperative outcomes, and a favorable safety profile in the treatment of severe congenital ptosis in children.