Risk of Recurrent Ptosis Repair Following Intraocular Surgery
Author: Tehila Shlomov
Base Hospital / Institution: Hadassah medical center
ePoster presentation
Abstract ID: 25-400
Purpose
The effect of intraocular surgery after ptosis repair on the risk of ptosis recurrence and reoperation is unclear, with implications for surgical planning and patient counseling. The aim of this study is to evaluate whether intraocular surgery following ptosis repair increases the risk of recurrent ptosis repair.
Methods
A retrospective cohort study using the TriNetX Global Collaborative Network included patients aged >50 years who underwent ptosis repair between 2005 – 2024, with a minimum follow-up of 1 year. The ptosis repair with subsequent intraocular surgery (PRIOS) cohort included patients who underwent intraocular anterior or posterior segment surgery within 1 month to 10 years after ptosis repair. The ptosis repair only (PRO) cohort included patients without intraocular surgery during the same period. Patients with conditions affecting eyelid mechanics or anatomy were excluded. Propensity score matching (PSM) was performed 1:1 for baseline sociodemographic characteristics and comorbidities. Sensitivity analyses evaluated risk at 5 and 10 years. Cox proportional hazards models estimated hazard ratios (HRs).
Results
After PSM, 1,598 patients were included in each cohort. The mean age was 71.8 years (standard deviation [SD], 6.9) in PRIOS and 72.1 years (SD, 7.3) in PRO. At 2 years, recurrent ptosis repair occurred in 38 vs. 16 patients, with incidence rates of 14.5 vs. 6.7 per 1,000 person-years, respectively (log-rank p = 0.008). The absolute risk was 2.4% in PRIOS vs. 1.0% in PRO (risk difference, 1.4%; 95% CI, 0.5–2.3%; p = 0.003). Intraocular surgery was associated with a greater than twofold increased risk of recurrent ptosis repair (HR, 2.16; 95% CI, 1.21–3.88). The association remained significant at 5 years (HR, 1.98; 95% CI, 1.27–3.10) and 10 years (HR, 1.67; 95% CI, 1.12–2.48).
Conclusion
Intraocular surgery after ptosis repair was associated with a significantly increased risk of recurrent ptosis repair, with the effect persisting over long-term follow-up. These findings support careful surgical sequencing and patient counseling to minimize recurrence risk.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Itay | Nitzan | Hadassah Medical Center |
| Shoham | Kubovsky | Hadassah Medical Center |
| Nadav | Shemesh | Hadassah Medical Center |
| Jaime | Levy | Hadassah Medical Center |
| Zvi | Gur | Hadassah Medical Center |
