Comparison of Mersilene mesh and autogenous fascia lata in correction of congenital blepharoptosis: a randomized clinical trial.

PURPOSE: To asses the functional results and complications of Mersilene mesh as an alternative to autogenous fascia lata in the management of low function ptosis.

METHODS: In a randomized clinical trial, 31 eyelids with poor levator function were operated on. In 16 eyelids Mersilene mesh (Group A) and in 15 eyelids autogenous fascia lata were used for frontalis suspension procedure (Group B).

RESULTS: Nine patients with congenital unilateral and 11 patients with bilateral ptosis underwent sling procedure. There were no differences between the two groups with regards to functional (lid fissure height stability) and cosmetic (lid margin contour) results. Eyelid fissure increase was 4.00-/+1.46 mm in Group A and 3.13-/+1.72 mm in Group B. Change in eyelid fissure in both groups was significant (p=0.00, paired t-test), but intergroup difference was not significant (p=0.141, independent sample t-test). Follow-up for Group A was 14.2 (range 6-26) months and for Group B was 15.1 (range 9-29) months. Dermatochalasis was seen more in Group B (B/A = 10/2) and extrusion of Mersilene mesh was seen in two cases of Group A and none of Group B. Early complications such as corneal epithelial defects and entropion and late complications such as undercorrection were comparable in the two groups.

CONCLUSIONS: Mersilene mesh with long-term functional results and low rate of complications is a suitable alternative to autogenous fascia lata as a suspensory material in ptosis surgery.