Incidence of lagophthalmos after aponeurotic ptosis repair

This study was designed to determine the incidence of lagophthalmos following aponeurotic ptosis repair, and to establish any predictive factors for its development. Data from a prospective, interventional, non-comparative case series was reviewed. Of these 164 eyelids with acquired involutional ptosis, 134 eyelids of 75 patients had both preoperative and postoperative photographs of the eyelids in the primary and gently closed positions, and were therefore analyzed for this study. Lagophthalmos was present in 23/38 (60%) of eyelids on the first postoperative day; in 27/81 (33%) one week after surgery; and persisted in 12/134 (9%) eyelids and 8/75 (11%) patients six to twenty weeks after surgery (mean 11 weeks). The lagophthalmos of these twelve eyelids ranged from 0.5 to 1.5 mm with a mean of 0.6 mm. Both the pre-existing lower scleral show and the final height of the eyelid following surgery were significant predictors of postoperative lagophthalmos. Neither eyelid excursion nor the degree of change in eyelid height from pre- to post-surgery was significantly associated with eyelid closure.