Blepharoptosis, at a tertiary care oculoplastic clinic
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Abstract
Objective: To determine the frequency, patterns, etiology and management outcomes of ptosis in patients presenting to an oculoplastic clinic.
Methods: This cross-sectional observational study was conducted from August 2022 to May 2023, at Hayatabad Medical Complex, Peshawar, Pakistan. Patients of all ages presenting with ptosis were included. Detailed history and ocular examination were performed. Ptosis was categorized as congenital or acquired, levator function was assessed and management options were documented. Surgical procedures and postoperative complications were recorded.
Results: Thirty-eight patients (56 eyes) were enrolled (mean age 16.4±17.1 years); 22 (57.9%) were male and 28 (73.7%) were children. Congenital ptosis accounted for 28 patients (73.7%) and unilateral involvement for 22 (57.9%). Levator function was poor in 14 (40%), fair in 20 (57.2%), good in one (2.8%); and un-assessable in 3 (7.9%) infants. Surgery was performed in 33 (86.8%) patients. Etiology was associated with age group (p<0.001) and gender (p=0.0017) and treatment modality (p=0.0001). Frontalis sling with 2/0 prolene was most commonly performed procedure (42.4%), followed by levator resection (33.3%); levator extirpation for Marcus Gunn jaw-winking (12.1%) and levator advancement (9.1%). Complication observed for Frontalis sling 2/0-Proline; Frontalis sling Silicone tube and Levator Extirpation with sling were 14.3% (n=2/14); 100% (n=1/1) and 50% (n=2/4) respectively. No complications were observed for levator resections after 3-4 months of follow-up.
Conclusion: Congenital ptosis predominated, especially in children. Surgical correction guided by levator function was effective. Certain sling techniques showed variable early complication rates, highlighting the need for careful procedure selection and close postoperative follow-up.
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