Ptosis surgery at a tertiary eye hospital: etiology, surgical techniques and complications
Author: Franziska Reinking
Base Hospital / Institution: LMU Munich
ePoster presentation
Abstract ID: 24-326
Purpose
Up to now, upper eyelid ptosis can be corrected by surgical procedures only. Aim of this retrospective study was to evaluate ptosis surgeries at our tertiary eye hospital.
Methods
Patients who underwent ptosis surgery from 2015-2023 at LMU eye hospital were analyzed retrospectively regarding demographic findings, etiology, surgical procedure, age at surgery, type of anesthesia, complications and recurrence rate.
Results
673 patients (57.1% female, 384; 42.9 % male, 289) with upper eyelid ptosis underwent ptosis surgery, 7.6% (51) of those had ptosis surgery elsewhere before. Etiology of ptosis was involutional (60.3%, 406), congenital (17.4%, 117), contact lens-associated (5.4%, 37), muscle dystrophy (7.8%, 49), trauma (2.1%, 14) and other/unclear (7.4%, 50). Mean age at surgery was 57 years (4 months to 96 years), 26 surgeries were performed in infants younger than 24 months. 88.3% (594) of the surgeries were performed under local anesthesia, 11.7% (79) under general anesthesia. 88.9% (598) underwent anterior levator reinsertion and resection (ALR), 59.0% of those (353) with additional upper eyelid blepharoplasty. 11.0% (74) underwent frontalis suspension and 0.2% (1) frontalis flap. 52.6% (354) had bilateral ptosis surgery, 60.5% (214) of those simultaneously and 39.6% (140) in two stages.
9.1% (61) of 673 patients received a second surgery in our clinic after on average 4 years (1 day to 21 years). Re-surgery was performed due to undercorrection (29.5%, 18), recurrence (59.0%, 36), overcorrection (4.9%, 3), upper eyelid entropion (1.6%, 1), conjunctival prolapse (1.6%, 1) and suture exposure after frontalis suspension (3.3%, 2).
Conclusion
Involutional ptosis is the etiology of more than half of the ptosis surgeries performed at our tertiary hospital, followed by congenital upper eyelid ptosis as the second most common etiology. The age cohort of treated patients varies from infants to seniors. ALR was by far the most common surgery method. Revision rate of all ptosis surgeries is 9.1%, mostly due to recurrence of ptosis, on average 4 years after primary surgery.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Anna | Schuh | LMU Munich |
| Christoph | Hintschich | LMU Munich |
