Abstract Listings 2024

Purpose

Evaluation of surgical results and patient satisfaction after frontal sling removal and maximal levator resection surgery in patients who had previously undergone frontal sling surgery but needed revision

Methods

Preoperative and postoperative 1st week, 1st month and 3rd month margin reflex distance-1 (MRD-1), amount of lagophthalmos, corneal staining pattern of the patients who underwent maximal levator resection with sling removal at Beyoglu Eye Training and Research Hospital between 2019-2023 were recorded. No staining was scored as 0, staining in the lower 1/3, 1, staining in the lower 1/2, 2, staining in the lower 2/3, 3 and total staining as 4. Punctate epitheliopathy (PE) severity was scored as 0-none, 1-mild, 2-moderate, 3-severe, 4-severe, 5-severe. A 4-question satisfaction questionnaire was applied to the parents.

Results

The mean age of total cases 13 (5 girls, 8 boys) were 10.31±4.64 years. Revision was planned in 11 cases due to ptosis and in 2 cases due to expojure. Preoperative lagophthalmos was 0.85±1.21 mm and levator function was 5.18±3.28 mm. Bell’s reflex was not observed in 5 cases. There was a significant increase in MRD-1 in all postoperative controls compared to preoperative (0.46±1.26) (p0. 05). Corneal staining score at postoperative week 1 (0.54±0.77) was significantly higher than preoperative (0.08±0.27) (p=0.04). At postoperative week 1, mild PE in 3 cases, 2 cases had moderate PE. In the questionnaire conducted with the parents, ‘satisfied’ was 9/13(69.2%), ‘moderately satisfied’ was 2/13(15.4%), ‘dissatisfied’ was 2/13(15.4%). The reason for dissatisfaction was inadequate MRD-1. To the question “Did you have a more vigorous appearance after the operation?”, 10(76.9%) yes, 3(23.1%) no, to the question “Would you do the same operation again?”, 11(84.6%) yes, 2(15.4%) no.

Conclusion

Maximal levator resection surgery is an approach that results in a satisfactory MRD-1, acceptable and manageable lagophthalmos.

Additional Authors

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