Outcomes of Posterior Approach Ptosis Surgery

Article Information

Title: Outcomes of Posterior Approach Ptosis Surgery

Authors: Taimoor Ashraf Khan, Muhammad Shahid, Saquib Naeem, Abdul Rauf, Talha Liaqat, Muhammad Adnan

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2023

Volume: 73

Issue: Supplementary 2

Language: English

DOI: 10.51253/pafmj.v73iSUPPL-2.9946

Keywords: BlepharoptosisRefractive ErrorConjunctivo-Muller resectionSurgical Ptosis repairUpper lid crease

Abstract

Objective: To assess surgical outcomes of posterior approach ptosis surgery i.e., Conjunctivo-Muller resection for mild to moderate simple congenital ptosis.
Study Design: Quasi Experimental Study.
Place and Duration of Study: Orbit and Oculoplastic Department, Armed Forces Institute of Ophthalmology, RawalpindiPakistan, a tertiary care ophthalmic facility for a period of 6 months from May to Dec 2022.
Methodology: A sample size of 22 was calculated. Data containing patient’s age, gender, pre-op MRD-1, upper lid crease, postOp MRD 1, inter-eye palpebral fissure height symmetry, post-Op Complications were documented on Microsoft Excel Sheet.
Results: Out of total 22 patients, 10(45%) were male and 12(55%) were females. There was a significant improvement in postoperative MRD1 a mean of 1.25±0.33 mm. The mean pre-Operative MRD 1 was 2.72±0.48 mm while mean post-Operative MRD 1 was 3.97±0.36 mm
Conclusion: Posterior approach blepharoptosis repair is a safe and effective method for correction of mild to moderate simple congenital ptosis provided a good case selection especially if patient has fair pre-operative upper lid crease. The surgery has an acceptable cosmetic outcome as there would be no scar mark on eyelid skin. Furthermore, for moderate to severe ptosis the procedure can be opted as an initial surgical trial depending on case-to-case basis.

Disclaimer: The following sections are produced through an intensive multi-stage analytical pipeline developed by DefinePK, utilizing advanced natural-language processing, domain-specific knowledge models, and automated cross-referencing systems. Despite the rigor and computational effort involved, the generated summary may still contain inaccuracies or incomplete interpretations. Users are strongly advised to verify all critical information against the original paper and its authoritative sources.

Research Objective

To assess surgical outcomes of posterior approach ptosis surgery (Conjunctivo-Muller resection) for mild to moderate simple congenital ptosis.

Methodology

Quasi-experimental study conducted at the Orbit and Oculoplastic Department, Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan, over 6 months (May-Dec 2022). A sample size of 22 patients (2-12 years old) with mild to moderate simple congenital ptosis and fair levator function was included. Data collected included age, gender, pre- and post-operative MRD-1, inter-eye palpebral fissure height symmetry, and post-operative complications. Data was documented on Microsoft Excel and analyzed using SPSS version 22.

Methodology Flowchart

                        graph TD;
    A["Study Design: Quasi-Experimental"] --> B["Patient Recruitment: 22 pediatric patients with congenital ptosis"];
    B --> C["Data Collection: Age, gender, pre/post-op MRD1, symmetry, complications"];
    C --> D["Data Analysis: Microsoft Excel, SPSS v22"];
    D --> E["Outcome Assessment"];
    E --> F["Conclusion: Posterior approach is safe and effective"];

Discussion

The study supports the Conjunctivo-Muller resection via posterior approach as a safe and effective method for mild to moderate simple congenital ptosis, particularly when there is a good pre-operative upper lid crease. The posterior approach offers cosmetic benefits by avoiding eyelid skin scars. While historically debated, the posterior approach has regained popularity due to potentially lower revision rates compared to the anterior approach. Case selection is crucial for optimal outcomes.

Key Findings

Out of 22 patients, 10 (45%) were male and 12 (55%) were female. There was a significant improvement in post-operative MRD1 with a mean increase of 1.25±0.33 mm. The mean pre-operative MRD1 was 2.72±0.48 mm, and the mean post-operative MRD1 was 3.97±0.36 mm. Post-operative symmetry of palpebral fissure height was <1.5mm in 16 (72.7%) patients. Common complications included overcorrection (18.20%) and undercorrection (18.20%).

Conclusion

Posterior approach blepharoptosis repair is a safe and effective method for correcting mild to moderate simple congenital ptosis, especially with good case selection and a fair pre-operative upper lid crease. It provides acceptable cosmetic results without eyelid scars. For moderate to severe ptosis, it can be considered as an initial surgical trial on a case-to-case basis.

Fact Check

1. Sample Size: The study included a sample size of 22 patients.
2. Gender Distribution: 10 (45%) patients were male and 12 (55%) were female.
3. MRD1 Improvement: There was a significant improvement in post-operative MRD1, with a mean increase of 1.25±0.33 mm.

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