DefinePK

Research Objective

To compare the frequency of good functional outcome of frontalis suspension surgery using silicone rod versus prolene 4/0 suture in simple congenital ptosis.

Methodology

Hospital Based Comparative Study conducted at the Department of Ophthalmology, Khyber Teaching Hospital, Peshawar, from June to August 2018. 70 randomly selected patients with simple congenital ptosis, poor levator function (≤5mm), moderate to severe ptosis, and good Bell's phenomenon, aged 5-25 years, were divided into two groups (A and B) of 35 patients each. Group A used prolene 4/0 suture, and Group B used a silicone rod for frontalis suspension. Good functional outcome was defined as a marginal reflex distance of ≥1 mm after 3 months. Data was analyzed using SPSS 20, with frequencies, percentages, mean, and standard deviation computed. Chi Square test was used for stratification of outcomes with age.

Methodology Flowchart

                        graph TD
    A["Patient Selection n=70, 5-25 yrs, simple congenital ptosis"] --> B["Randomization"];
    B --> C["Group A: Prolene 4/0 Suture n=35"];
    B --> D["Group B: Silicone Rod n=35"];
    C --> E["Frontalis Suspension Surgery Prolene"];
    D --> F["Frontalis Suspension Surgery Silicone Rod"];
    E --> G["Post-operative Assessment 3 months"];
    F --> G;
    G --> H["Evaluate Functional Outcome"MRD""];
    H --> I["Data Analysis SPSS, Chi Square"];
    I --> J["Conclusion"];                    

Discussion

The study found that prolene 4/0 suture achieved better functional outcomes in frontalis suspension surgery for simple congenital ptosis compared to silicone rod. The findings are consistent with some previous studies, though variations exist due to population differences and study designs. The statistical significance of good functional outcome in older age groups (16-25 years) suggests a potential age-related factor.

Key Findings

A total of 88.57% of patients in Group A (prolene 4/0 suture) achieved good functional outcome, compared to 62.85% in Group B (silicone rod). Good functional outcome was statistically significant in the age group of 16-25 years (p=0.046). The mean age in Group A was 12±6.31 years, and the mean procedure duration was 52±3.08 minutes. In Group B, the mean age was 15±4.76 years, and the mean procedure duration was 55±1.82 minutes.

Conclusion

In simple congenital ptosis, prolene 4/0 suture achieved good functional outcome and an excellent safety profile in comparison to frontalis suspension using a silicon rod.

Fact Check

1. Number of patients: The study included 70 randomly selected patients, divided into two groups of 35 each. (Confirmed in Results section).
2. Good functional outcome in Group A: 88.57% of patients in Group A achieved good functional outcome. (Confirmed in Results section, Table III).
3. Statistical significance for age group 16-25: Good functional outcome was statistically significant in the age group of 16-25 years (p=0.046). (Confirmed in Results section, Table IV).

Mind Map