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Livia Teo, Stephanie Lang, Se Ji Jung, Gillian Teh; The Anterior Approach for Contact Lens Related Ptosis Correction. Invest. Ophthalmol. Vis. Sci. 2018;59(9):85.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the surgical outcomes of anterior approach surgery for the correction of contact lens(CL) related ptosis.
This was a retrospective comparative study. Subjects were recruited from Oculoplastic specialty clinics over a 4 year period. Surgery was performed via an anterior approach. Clinical data was recorded, and preoperative and postoperative photographs of patients were taken to grade the surgical outcome.
A total of 93 eyelids in 85 patients with CL wear associated ptosis were matched with 93 eyelids from 91 patients with aponeurotic ptosis. Patients in the CL group were significantly younger (44.2±12.4 years) than those in the aponeurotic group (50.9±7.9 years)(p<0.001). There were more females than males in both groups (p< 0.05). There was a trend towards more unilateral ptosis correction in the CL group (57%) compared to the aponeurotic group (44.1%) but this was not statistically significant(p=0.078). More patients in the aponeurotic group underwent surgical correction of their ptosis for occlusion of visual axis (n=85;91.4%) as compared to the CL wear group (n=73;78.5)(p<0.05); while more patients in the CL group underwent surgical correction of their ptosis for a cosmetic indication (n= 19; 20.4%) as compared to the aponeurotic group (n=8;8.6%)(p< 0.05). There was no significant difference in preoperative margin reflex distance 1(MRD 1) (p=0.835) and levator function p=0.454) between the two groups. Levator repair was the preferred anterior surgical approach for the correction of ptosis in CL group (n=87;93.7%) and the aponeurotic group (n=89;95.7%) (p=0.497). A similar post-operative surgical success, as defined by MRD1 >2mm, was achieved in both groups (81.2% in the CL group; 84.5% in the aponeurotic group)(p=0.337). Lid height symmetry of ≤1mm (p=0.712), good lid contour (p=0.168) and lid crease symmetry (p=0.590) was comparable in both groups. However, in terms of subjective grading of surgical outcome, satisfaction scores were lower in the CL group compared to the aponeurotic group (p< 0.05). There was no significant difference in post-operative complications between both groups (p=0.278).
The anterior surgical approach achieves good functional and cosmetic outcomes in the correction of CL related ptosis when compared to aponeurotic ptosis.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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