The Recurrence of Ptosis after Correction Surgery Is Associated with Refractive Error

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Refractive Error Analysis

Background:

• Congenital ptosis correction surgery outcomes often overlook refractive error's role.
• Previous research focused on complications, surgical techniques, and materials, not refractive changes.

Purpose of the Study:

• To investigate the association between refractive error and recurrence after frontalis muscle flap suspension (FMFS) surgery for simple congenital ptosis in pediatric patients.
• To identify factors influencing ptosis recurrence post-surgery.

Main Methods:

• Retrospective analysis of 111 eyelids from 85 pediatric patients with simple congenital ptosis treated with FMFS.
• Assessment of postoperative eyelid height, cycloplegic refraction (pre- and post-surgery), and recurrence defined as marginal reflex distance 1 (MRD1) <1 mm.

Main Results:

• Postoperative cylindrical diopter and laterality were significantly associated with ptosis recurrence (adjusted ORs < 0.5).
• Preoperative MRD1 also showed an association with recurrence (adjusted OR = 0.617).
• No significant differences in spherical diopter or spherical equivalent (SE) were found between recurrence and non-recurrence groups.

Conclusions:

• Refractive error, particularly postoperative astigmatism and laterality, is a significant factor in ptosis recurrence after FMFS in pediatric congenital ptosis.
• Timely refractive correction and amblyopia treatment are recommended to potentially decrease ptosis recurrence rates.