This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

Complication rates following frontalis sling surgery may differ based on the closure technique, sling material, and perioperative antibiotics utilized, according to research presented at the 2021 meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery meeting. Frontalis sling surgery is intended to correct congenital or acquired blepharoptosis with poor or absent levator palpebrae superioris function. 

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The investigators, from Bascom Palmer Eye Institute, University of Miami-Miller School of Medicine, conducted a retrospective chart review examining frontalis sling surgeries performed at a single center between January 1, 2010 and December 1, 2020. Patients ranged in age from 0 to 65 years, and patient follow-up was 1 month or longer. Data collected included type of sling material, use of intraoperative antibiotics, eyelid closure technique and complications, and brow closure technique and complications. Eyelid and brow complications assessed included sling exposure, granuloma, and infection. Overall, 185 frontalis sling surgeries were reviewed. 

Researchers found age at time of surgery was not significantly correlated with the complication rate. In addition, they noted no significant correlation between sling material and complication rates (P =.13). They reported no significant correlation between the complication rate and eyelid closure technique (P =1.0) or brow closure technique (P =.7). Use of antibiotics was also not associated with a significantly lower rate of complications or infection (P =.7). 

While the small sample size in their study could be a limitation, the investigators findings do not support routine perioperative use of antibiotics such as cefazolin in frontalis sling surgery.

Visit Ophthalmology Advisor’s conference section for complete coverage of the ASOPRS 2021 Fall Scientific Symposium.



Topilow N, Gutkind N, Stevens S, et al. Effect of antibiotics use, sling material, and closure technique on frontalis sling surgical outcomes. Poster presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.