Abstract ID: 26-153
Congenital Ptosis – pre, intra and post-operative considerations
Author: Lizzie Rosen Base Hospital / Institution: University Hospitals Bristol and Weston
Presentation Type: ePoster Presentation
Purpose
Ptosis is a common oculoplastic condition that often requires surgical correction due to visual, physical and psychosocial factors. Clinicians’ assessment and management of congenital ptosis in particular can vary widely. The aims for this study were to:
– Identify practice patterns for managing congenital ptosis among international oculoplastic surgeons.
– Consider ‘gold-standard’ practice in the management of congenital ptosis.
Methods
A web-based questionnaire was distributed to all 280 members of the British Oculoplastic Surgery Society in March 2025. Results were collected from March to May 2025. Completed surveys from 107 (38%) respondents were analysed quantitatively using Google sheets.
Results
A wide range of participants completed the survey from 6 continents.
Pre-operative: Levator function (92.7%), MRD (87.2%), Bell’s phenomenon (84.4%) and Strabismus (81.7%) were most frequently assessed. Alternative imaging or measurements were not commonly used.
Timing of Surgery: In non-amblyogenic eyes, preferred age at surgery was 4-6 years old. In deprivational amblyopia, preferred age at surgery was much younger; as young as 4 weeks old.
Intra-operative: The preferred technique in good levator function (>10mm) was levator advancement/resection (76.4%), and in poor levator function (≤4mm) was frontalis suspension (66.7%). Bilateral surgery was not commonly offered.
Post-operative: The most common post-operative issue was asymmetry (62.4%), the lid sitting too low (48.1%), lid contour problems (28.3%), skin crease problems (20.8%), and the lid sitting too high (15.1%). There was a range in preferred timing for revision surgery from 6 months (37.1%). Almost 50% of respondents reported their revision rate within 2 years was ≤10%.
Conclusion
These results demonstrate an international perspective on the assessment and management of congenital ptosis. Reassuringly, there was overall consensus amongst surgeons. A guidance document has been suggested to be used as a blueprint when approaching cases of congenital ptosis.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Harry | Rosen | Hampshire Hospitals NHS Foundation Trust (1), University of Utrecht (2) |
| Aoife | Naughton | Portsmouth Hospitals University NHS Trust |