ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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Comparing the Outcomes of Posterior vs Anterior Approach White-Line Advancement Ptosis Repair

Author: James Young
ePoster Number: 229


To compare the efficacy and predictability of posterior vs anterior approach white line levator advancement ptosis repair.


The operating consultant moved from posterior approach white-line advancement (P-WLA) to anterior approach white line advancement (A-WLA) surgery in 2017. A retrospective analysis of all patients with primary aponeurotic ptosis undergoing anterior approach white-line advancement between May 2017 and February 2020 was performed. This was compared to a retrospective analysis of all patients with ptosis undergoing posterior-approach repair using white-line advancement between January 2010 to September 2014.


59 eyes were managed by A-WLA and 48 were managed by P-WLA. All procedures were primary ptosis repair. Concurrent blepharoplasty was performed in 22 (37%) eyes during A-WLA surgery and 28 (57%) eyes of P-WLA surgery. The mean age was 71 yrs (range 21-85yrs) for A-WLA and 67.5 yrs (range 20-89 yrs) for P-WLA. Follow up was on average 5.9 months (+/- 6.9mths) for A-WLA and 3.1 mths (+/- 2.3mths) for P-WLA. Surgical success was defined as a postoperative MRD of greater or equal to 2mm and less than or equal to 4.5mm, good eyelid contour, inter-eyelid height asymmetry of less than or equal to 1mm and patient satisfaction. For A-WLA 95 % were successful. 2 eyes were unsuccessful due to under correction and 1 eye was under corrected with a medial droop. For P-WLA 92% were successful. The 4 cases which were unsuccessful, were due to under correction. No eyes had an unsatisfactory contour.


We present the first series comparing anterior to posterior approach white line advancement ptosis repair since it was first described in the literature. Both techniques have excellent outcomes resulting in a good height and contour. Failure, although uncommon, was mostly due to under correction.

Additional Authors

First nameLast nameBase Hospital / Institution
VikeshPatelRoyal Preston Hospital

Abstract ID: 21-120