Analysis of visual outcomes and complications following levator resection for unilateral congenital blepharoptosis without strabismus

Wu, Shu-Ya; Ma, Lih; Huang, Hsin-Hui; Tsai, Yueh-Ju

doi:10.4103/2319-4170.113854

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…Conversely, waiting to perform surgical correction at an older age allows patients to be more cooperative with examinations, producing better anatomical results and refractive stability. Wu et al 11 reported that there was no signi cant visual bene t from surgical correction of congenital ptosis in patients at 2 years or younger, compared with patients operated upon between 2 to 5 years of age. Based on a retrospective chart review of 62 patients, Cadera et al 12 reported that changes in cylinder were not statistically signi cant between patients in their younger and older-age groups (< 4 years old and ≥ 4 years old, respectively).…”

Section: Discussionmentioning

confidence: 99%

Corneal Astigmatism Changes After Ptosis Correction in Two Age Groups of Patients with Congenital Ptosis

Lekskul

Tangphikunatam

Tangtammaruk

2021

Preprint

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Purpose: To evaluate postoperative corneal astigmatism changes after ptosis correction in groups of young and older patients with congenital ptosis.Patients and Methods: A prospective cohort study of 28 patients (56 eyes) with congenital ptosis enrolled at Ramathibodi Hospital was performed from April 2018 to June 2019. Within this group of patients there were 6 cases of bilateral congenital ptosis and 22 unilateral cases of congenital ptosis forming a total of 34 individual ptotic eyes for the study. The patients were categorized into two groups: early-age group (aged ≤5 years,) comprising of 14 eyes and older-age group (aged >5 years) comprising of 20 eyes. The preoperative visual acuity, amblyopic status, ptosis severity, and refractive error of both groups were evaluated prior to ptosis correction. All patients underwent ptosis correction with either levator resection or frontalis sling. Following the correction, the refractive error was measured after a follow-up period of at least 6 months. The astigmatism results were classified into three subgroups: with-the-rule, against-the-rule and oblique astigmatism.Results: The mean age at diagnosis was 8.91 ± 7.05 years. From the study group, amblyopia was found in 13 out of 28 patients (46.4%). The most common type of astigmatism was with-the-rule astigmatism, making up 24 out of 34 ptotic eyes (70.6%). A postoperative astigmatism change of >0.50 diopters was found in 4 out of14 eyes (28.6%) in the early-age group and in 6 out of 20 eyes (30.0%) in the older-age group (Rate ratio, 1.43; 95% CI, 0.34–6.07). Conclusion: Astigmatism was reduced following ptosis correction, with no statistically significant difference in the amount of reduction between the two age groups. As there is no significant difference, surgical correction can be deferred in patients of all age groups with anisometropic amblyogenic ptosis until appropriate surgical planning is possible.

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Section: Discussionmentioning

confidence: 99%

Corneal Astigmatism Changes After Ptosis Correction in Two Age Groups of Patients with Congenital Ptosis

Lekskul

Tangphikunatam

Tangtammaruk

2021

Preprint

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“…In another study by Wu et all. 20 , levator resection was performed in 84 children who had unilateral congenital ptosis and surgical success rate was reported as 84.5%. Another study from Iran, Abrishamiet all.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis

Balsak¹,

Dag²,

Güneş³

et al. 2019

Dicle Tıp Dergisi

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Objective: This study aimed to evaluate the outcomes of maximal levator resection in cases of congenital myogenic ptosis with poor levator function. Method: Thirty-threeptotic eyelids of 30 cases undergoing maximal levator resection were retrospectively included. There were 18 male and 12 female cases. The mean age of the cases was 12.55±5.3 years (range, 4-26 years). For all eyes, vertical palpebral aperture, margin reflex distance, levator functions, and upper eyelid crease height were measured. Ptosisseverity was "mild" when the eyelid elevation was ≤2 mm; "moderate" when the eyelid elevation was 3 mm; and "severe" when the eyelid elevation was ≥4 mm. The mean age of the cases (18 males and 12 females) was 12.55±5.3 years (range, 4-26 years). Results and Conclusion: The mean ptosis severity (vertical palpebral aperture) was 5.136 mm preoperatively and 0.818 mm at the postoperative Month 3 (p<0.001). Surgical outcomes were successful in 26 eyes (78%), satisfactory in 4 eyes (12%), and unsuccessful in 3 eyes (9%).Conclusively, successful outcomes were obtained after maximal levator resection in ptosis cases with poor levator functionin most of casses.

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“…Levator muscle resection is a standard procedure for ptosis correction and a good Bell`s phenomenon is a pre- requisite for ptosis surgery [4, 5]. Post- operative rehabilitation depends on the recovery of Bell`s phenomenon and varies from patient to patient.…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Amount of Resection and Time for Recovery of Bell’s Phenomenon after Levator Resection in Congenital Ptosis

Goel

Kishore

Nagpal

et al. 2017

TOOPHTJ

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Background: Recovery of Bell`s phenomenon after levator resection is unpredicatable. Delayed recovery can result in vision threatening corneal complications.Aim:To study the variability of Bell’s phenomenon and time taken for its recovery following levator resection for blepharoptosis and to correlate it with the amount of resection.Methods:A prospective observational study was conducted on 32 eyes of 32 patients diagnosed as unilateral simple congenital blepharoptosis who underwent levator resection at a tertiary care center between July 2013 and May 2015. Patients were followed up for 5 months and correction of ptosis, type of Bell`s, duration of Bell`s recovery and complications were noted.Results:The study group ranged from 16-25 years with 15:17 male: female ratio. There were 9 mild, 16 moderate and 7 severe ptosis. Satisfactory correction was achieved in all cases. Good Bell`s recovery occurred in 13 eyes on first post-op day, in 2-14 days in 19 eyes and 28 days in 1 eye. Inverse Bell`s was noted along with lid oedema and ecchymosis in 2 patients. Large resections (23-26mm) were associated with poor Bell`s on the first postoperative day (p=0.027, Fisher`s exact test). However, the duration required for recovery of Bell`s phenomenon did not show any significant difference with the amount of resection. (p=0.248, Mann Whitney test). Larger resections resulted in greater lagophthalmos (correlation=0.830, p<0.0001). Patients with recovery of Bell`s delayed for more than 7 days were associated with greater number of complications (p=0.001 Fisher`s Exact Test).Conclusion:Close monitoring for Bell`s recovery is required following levator resection.

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Analysis of visual outcomes and complications following levator resection for unilateral congenital blepharoptosis without strabismus

Cited by 13 publications

References 27 publications

Corneal Astigmatism Changes After Ptosis Correction in Two Age Groups of Patients with Congenital Ptosis

Corneal Astigmatism Changes After Ptosis Correction in Two Age Groups of Patients with Congenital Ptosis

Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis

The Relationship of Amount of Resection and Time for Recovery of Bell’s Phenomenon after Levator Resection in Congenital Ptosis

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