The Differences in Clinical Characteristics and Outcomes of Ptosis Surgery: A Report of 260 Cases

Background Blepharoptosis can be cosmetically distressing and obstruct upper visual fields. We aimed to examine the preoperative, intraoperative and postoperative characteristics of various ptosis repair surgeries at a major referral center Methods We retrospectively reviewed patients > 18 years of age who underwent ptosis repair surgery between February 2009 and December 2021 at a tertiary center. Congenital cases were excluded. Sub-analysis by ptosis type, surgical technique, and anterior vs. posterior approach surgery was performed. Main outcome measures included residual ptosis defined as Margin-to-Reflex Distance 1 < 2.5 mm at last follow-up, as well as clinically significant residual ptosis requiring re-do surgery. Results A total of 260 patients were included, with mean follow up of 259 ± 30 days (28–3771 days). Main indication for ptosis surgery was aponeurotic (222 patients). 164 (63.1%) patients underwent Müller's Muscle-Conjunctival Resection, 51 (19.6%) Fasanella-Servant, 35 underwent External Levator Advancement (13.5%), and 10 (3.8%) Frontalis-Sling suspension. Post-op residual ptosis and need for correction was seen in 66 eyes (25.4%) and 48 eyes (18.5%), respectively; however, differences were not significant between groups when analyzing by ptosis type (p ≥ 0.116), surgery type (p ≥ 0.444) and anatomical approach (p = 0.835). Conclusions No significant differences in residual ptosis, as well as referral for re-do surgery were shown between groups when analyzed by ptosis type, surgical choice, as well as anterior vs. posterior approach surgery. Ptosis corrective surgery can be completed using a variety of techniques with good success given that the correct surgical candidate and surgery are chosen.