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

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.