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Critical pre- and postoperative factors in evaluating ptosis.

Jordan N Cornwell1, Claire S Smith1, Katherine M Lucarelli1

  • 1Division of Orbital and Ophthalmic Plastic Surgery, Doheny and Stein Eye Institutes, University of California, Los Angeles, Los Angeles, CA, United States.

Frontiers in Ophthalmology
|August 20, 2025
PubMed
Summary

Oculoplastic surgeons reached a consensus on key factors for evaluating blepharoptosis (droopy eyelid). Levator function and marginal reflex distance are crucial for assessing ptosis before and after surgery.

Keywords:
delphi techniquenominal group techniquepre-operative assessmentptosis repairptosis-related outcomes

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Surgical Evaluation

Background:

  • Blepharoptosis repair is a frequent global eyelid surgery.
  • Techniques and outcome assessments for blepharoptosis vary significantly worldwide.

Purpose of the Study:

  • To establish a consensus among oculoplastic surgeons regarding critical pre- and postoperative factors in ptosis evaluation.
  • To identify and prioritize variables essential for consistent ptosis assessment.

Main Methods:

  • Oculoplastic surgeons were surveyed on important pre- and postoperative ptosis evaluation variables.
  • A nominal group meeting was conducted to achieve consensus on the top 10 factors.
  • Statistical analysis, including student's t-test, was used to compare Likert scale responses.

Main Results:

  • 163 surgeons provided 1,909 responses, highlighting levator function (91.4%) and upper marginal reflex distance (87.7%) as paramount.
  • Secondary causes of ptosis (75.5%), corneal health (58.9%), and brow position (55.2%) were also highly rated.
  • Consensus factors were categorized into Causes of Ptosis, Surgical Planning, Anatomy and Symmetry, and Ptosis-Related Quality of Life.

Conclusions:

  • A consensus was achieved by ASOPRS oculoplastic surgeons on essential variables for ptosis evaluation.
  • This consensus provides a standardized framework for assessing blepharoptosis.