Comparison of Silastic and Banked Fascia Lata in Pediatric Frontalis Suspension

PURPOSE To compare the use of Silastic and banked fascia lata in pediatric frontalis suspension surgery for functional success, ptosis recurrence, and infection and granuloma rates. METHODS This retrospective study analyzed the medical records of 72 patients who underwent 131 frontalis suspension operations using either Silastic or banked fascia lata during the past 12 years at Children’s Hospital at Westmead, Sydney, Australia. RESULTS Functional success rates for primary frontalis suspension procedures were not significantly different for banked fascia lata and Silastic (60% versus 67.2%, respectively; P = .4666). Infection and granuloma rates also were not significantly different (7.1% for banked fascia lata versus 15.2% for Silastic; P = .1381). There was, however, a statistically significant difference between the two materials in ptosis recurrence (35.3% for banked fascia lata versus 13% for Silastic; P = .0062). CONCLUSIONS Silastic was significantly better than banked fascia lata in terms of ptosis recurrence. Both materials were comparable in terms of functional success after one procedure and in infection and granuloma rates. Given the conflicting evidence presented in the literature, large prospective studies are needed to compare the use of the most common synthetic materials with banked fascia lata in pediatric frontalis suspension. J Pediatr Ophthalmol Strabismus 2006;43:212-218. AUTHORS The authors are from the Department of Pediatric Ophthalmology, Children’s Hospital at Westmead, Sydney, Australia. Drs. Hersh and Martin are also from the Save Sight Institute, Sydney Eye Hospital, Sydney, Australia. Originally submitted March 9, 2005. Accepted for publication June 20, 2005. Address reprint requests to Dov Hersh, BCom(IT), MBBS(Hons), Department of Ophthalmology, Children’s Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Sydney, Australia.