Segmental removal of infected frontalis sling

Abstract

Congenital ptosis is one of the most common oculoplastic diseases of infancy. Where there is poor levator function, a frontalis sling is the procedure of choice. Here, we describe 2 cases of frontalis sling extrusion that were managed by segmental sling removal, with favorable results. In case 1, an infant developed silicone extrusion 2 months after bilateral frontalis sling implantation. The exposed segment was excised, and the area healed quickly without recurrence of infection and lid height remained optimal. Case 2 developed recurrent brow abscesses during the 3 years following bilateral frontalis sling. Surgical revision involved excision of the involved sling segment for definitive control of the chronic recurrent infection. Adjustment at the time of segmental excision resulted in improved eyelid position. These cases demonstrate that postoperative infection with implant exposure can be managed by partial sling removal, which may be the preferred procedure in children in order to minimize the number of procedures and exposure to general anesthesia.