Repeated ptosis surgery

1 October 2018 | Fiona Rowe (Prof) | EYE - Paediatrics, EYE - Strabismus

The purpose of this study was to evaluate the amounts of surgery for the treatment of residual or recurrent simple congenital ptosis and to investigate the relationship between long-term surgical success rates with clinical and surgical factors. This was a retrospective study of 84 eyes of 77 patients (44 male, 33 female) with a mean age at diagnosis of 6.4±0.6 years. First surgery was at a mean of 8.1±0.5 years with a mean follow-up period of 8.4±0.7 years. Mild, moderate and severe ptosis was present in six, 32 and 46 eyes respectively. As initial surgery, levator resection was used in 29 eyes and frontalis suspension in 55 eyes. Additional surgery was required in 20 eyes with a mean of 31.7±26.6 months to the second surgery. Surgical success was achieved for 52 eyes with a single procedure; success was directly associated with preoperative levator function and margin-reflex distance. For repeat frontalis suspension surgery, successful outcome was achieved in 13 of 20 eyes. Common complications included nocturnal lagophthalmos, superficial punctate epithelial defects (in 10 eyes). Surgical success was inversely proportional to the ptosis severity. The authors conclude that repeat surgery for recurrence is beneficial for optimum outcomes.