Identifying Syndromic Ptosis in a Tertiary Eye Care Center: A Retrospective Analysis
Author: Mohammed Alshehri
Base Hospital / Institution: King Khaled Eye Specialist Hospital
ePoster presentation
Abstract ID: 24-248
Purpose
The primary aim of this study is to investigate the prevalence and incidence of syndromic ptosis and compare it to non-syndromic congenital ptosis. We also aim to identify the different ophthalmic morbidities, rate of complications, and need for multiple surgeries.
Methods
A single-institution retrospective review. The definition of syndromic ptosis included blepharophimosis syndrome (BPES), monocular elevation deficiency syndrome (MED), Marcus Gunn jaw-winking syndrome (MGJWS), congenital fibrosis of extraocular muscles (CFEOM), chronic progressive external ophthalmoplegia (CPEO), Kearns-Sayre Syndrome (KSS), congenital Horner’s syndrome, and congenital third nerve palsy.
Results
149 (4.9%) out of 2910 patients were identified as having syndromic ptosis. The most common syndromes were BPES, MGJWS, and MED. CFEOM was the most common syndrome associated with poor Bell’s phenomenon. Around 40.9% of BPES patients needed repeated ptosis surgery. The frontalis suspension procedure was the most common procedure resulting in complications, with 45 recorded complications. Undercorrection was the most common complication overall, presenting in 31 patients, followed by lagophthalmos in 17 patients. Multiple factors were evaluated in association with the success rate. We only found a clinically significant association between the need for multiple surgeries and poor outcomes.
Conclusion
Many studies have reported an association between amblyopia and blepharoptosis, Thapa et al. found amblyopia in 19.2% of congenital ptosis. In our study, amblyopia was found in 15 patients (33.3%) of MGJWS. Although in our study we could not identify any preoperative, perioperative, or postoperative factors affecting the success rate in different syndromes, the number of repeat surgeries was associated with poor outcomes in patients with BPES. Ho et al. identified three factors associated with excellent outcomes: levator resection surgery, better preoperative MRD1, and the absence of MGJWS.
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