Purpose

To evaluate the effectiveness of a single-stage approach combining keratopigmentation and ptosis surgery for cosmetic rehabilitation in eyes with poor visual potential and anterior segment disfigurement.

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Methods

Retrospective case series of 27 eyes of 27 patients undergoing combined keratopigmentation and ptosis repair. Indications included disfiguring corneal pathology with ptosis. Keratopigmentation was performed using superficial, intrastromal, or combined techniques, with anterior levator repair. Primary outcome was change in MRD1. Secondary outcomes included palpebral aperture, upper lid crease height, complications, need for re-intervention, and cosmetic satisfaction.

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Results

MRD1 improved from 2.05 ± 1.12 mm to 4.24 ± 0.76 mm (mean change 2.19 mm, p < 0.001). Palpebral aperture increased from 6.77 ± 2.07 mm to 10.41 ± 1.33 mm (p < 0.001), and upper lid crease height decreased from 6.48 ± 1.47 mm to 3.92 ± 0.97 mm (p < 0.001). Keratopigmentation retouching was required in 41% and ptosis revision in 22%. Intraoperative complications occurred in 11% and transient postoperative complications in 22%. Pigment fading was observed in 26%. Cosmetic outcome was rated good in 78% and fair in 22%.

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Conclusion

Combined keratopigmentation and ptosis repair provides measurable improvement in eyelid position and cosmetic appearance in eyes with poor visual potential. Despite moderate retreatment rates, outcomes remain stable with high patient satisfaction. This single-stage approach reduces the need for staged procedures in complex cosmetic cases.

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Additional Authors

First name	Last name	Base Hospital / Institution
María Alejandra	Amesty	Vissum Grupo Miranza Alicante

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