# Early Expanded Polytetrafluoroethylene Sheet Removal Due to Postoperative Infection in Frontalis Suspension Surgery Preserves Eyelid Elevation and Curvature

## TL;DR

Removing an ePTFE sheet early due to infection after eyelid surgery preserves eyelid function and shape.

## Contribution

Demonstrates successful early removal of ePTFE sheet in eyelid surgery due to infection, preserving functional and aesthetic outcomes.

## Key findings

- Early removal of ePTFE sheet at six weeks post-surgery preserved eyelid elevation and curvature.
- Prompt removal prevented complications from infection while maintaining surgical results.
- Trimming the ePTFE sheet at two weeks helped avoid further infection risks.

## Abstract

In frontalis muscle suspension surgery for treating congenital ptosis, the use of expanded polytetrafluoroethylene (ePTFE) sheets often yields stable postoperative outcomes; however, it also carries the risks of foreign body reactions and infection, with few reports describing the detailed course of treatment in such cases. A 15-year-old girl was referred for management of right congenital ptosis. Preoperative margin reflex distance-1 (MRD-1) measurements were 1.5 mm on the right and 4.5 mm on the left, with corresponding levator function of 5 mm and 14 mm on the right and left, respectively. Levator advancement was considered insufficient to correct the asymmetry; therefore, a frontalis muscle suspension using an ePTFE sheet was planned. After positioning the sheet and forming double eyelids, MRD-1 was confirmed to be symmetrical bilaterally (4.5 mm), the curvature was appropriate, and the incision was closed. At the two-week postoperative suture removal, a small portion of the ePTFE sheet was visible through a gap in the wound at the eyelid margin; therefore, it was trimmed, and wound closure was subsequently confirmed. Six weeks after surgery, the patient presented with fever, eyelid redness, and pain. Infection was noted at the eyelid margin wound site; therefore, the ePTFE sheet was removed, followed by wound irrigation. After prompt ePTFE sheet removal, adequate eyelid elevation and curvature were equivalent to those prior to sheet removal, making this protocol a viable treatment option for similar cases.