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Safety and Long-term Outcomes of Congenital Ptosis Surgery: A Population-Based Study
Insights
Most children with ptosis need one surgery, but some require revisions. Postoperative lagophthalmos is common after childhood ptosis surgery, though dry eye is rare.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Ptosis, or drooping eyelid, can affect vision and appearance in children.
- Surgical intervention is often necessary to correct ptosis in pediatric patients.
- Long-term outcomes of childhood ptosis surgery are crucial for understanding treatment efficacy.
Purpose of the Study:
- To evaluate the long-term results of surgical correction for childhood ptosis.
- To analyze the frequency of repeat surgeries and associated complications.
- To assess the incidence of amblyopia, lagophthalmos, and dry eye after ptosis surgery.
Main Methods:
- Retrospective review of medical records for Olmsted County, Minnesota residents.
- Inclusion criteria: diagnosis of blepharoptosis and surgery before age 19 (1965-2010).
- Data collected: age at surgery, procedure type, follow-up duration, revisions, amblyopia, lagophthalmos, and dry eye.
Main Results:
- 47 children underwent ptosis surgery; median age at first surgery was 5.6 years.
- 31.9% required a second procedure, and 6.4% required a third.
- Lagophthalmos occurred in 40.4% of patients; symptomatic dry eye was rare (6.4%).
Conclusions:
- Childhood ptosis surgery often requires a single procedure, but a notable percentage need revisions.
- Postoperative lagophthalmos is a frequent complication, whereas symptomatic dry eye is uncommon.
- This population-based study provides insights into the long-term surgical management of pediatric ptosis.
Purpose:
To report the long-term outcomes of childhood ptosis surgery in a population-based setting over a 46-year period.
Methods:
In this population-based cohort study, the medical records of all patients who were residents of Olmsted County, Minnesota, diagnosed as having blepharoptosis and having undergone surgical management prior to 19 years of age (between January 1, 1965, and December 31, 2010), were retrospectively reviewed. Age at time of surgery, type of surgery, duration of follow-up, number and nature of revisions, degree of amblyopia, and postoperative lagophthalmos and dry eye were documented.
Results:
Forty-seven children meeting inclusion criteria underwent ptosis surgery. The median age at time of first surgery was 5.6 years (range: 1.5 to 17.7 years). Fifteen of 47 (31.9%) patients required a second procedure. Three of 47 (6.4%) patients underwent three procedures. The median time was 1.1 years (range: 0.03 to 7.8 years) between the first and second surgery and 6.0 years (range: 0.3 to 6.1 years) between the second and third procedure. Seven of 47 (14.9%) patients had amblyopia. Nineteen of 47 (40.4%) patients were noted to have lagophthalmos and 3 of 47 (6.4%) presented for symptomatic dry eye postoperatively.
Conclusions:
In this population-based setting, more than half of the children with ptosis required only a single surgical procedure, although a significant proportion required two procedures. Postoperative lagophthalmos is common, but symptomatic dry eye is rare. [J Pediatr Ophthalmol Strabismus. 2016;53(4):212-217.].
