A review of ptosis surgery techniques performed by British Oculoplastic Surgical Society members

Involutional ptosis repair is the signature procedure of Oculoplastic surgeons, with significant variation in approach. We aimed to assess the surgical approach currently used by BOPSS members for routine involutional ptosis repair.

A prospective 7-question survey was carried out of BOPSS members, assessing for prevalence of anterior- versus posterior-approach, bilateral simultaneous versus staged surgery, and approach to clinical photography.

Of the respondents (n = 73), for routine involutional ptosis repair, 66% perform predominantly anterior-approach ptosis repair, 18% perform a mix of either anterior or posterior approach depending on the patient, and 16% perform predominantly posterior-approach ptosis repair. In bilateral ptosis, most respondents (84.9%) perform bilateral simultaneous surgery in one sitting, versus performing staged surgery (15.1%). Clinical photography is routinely obtained pre-operatively by most respondents (74%). Respondents varied in time post completion of training (CCT); the largest group (35.6%) had >15 years post certificate of (CCT) experience. Approach was not associated with experience.

Anterior-approach ptosis repair remains the most common approach to ptosis repair in this cohort, though posterior approach is increasing in popularity. Bilateral simultaneous surgery is most often performed, though not by all surgeons. Approach does not vary with experience level.