Surgical Outcomes of Pediatric Blepharoptosis.

Abstract

Objectives: The results of ptosis surgery and revision surgery performed in blepharoptosis of different etiologies in the paediatric age group were evaluated.

Methods: The 78 eyes of 66 patients followed up at our clinic between 2020 and 2024 were retrospectively examined. The patient's age, gender, etiology, preoperative and postoperative Best Corrected Visual Acuity (BCVA), levator function, Margin Reflex Distance-1 (MRD-1), surgical techniques and revisions performed, amount of lagophthalmos, Bell's phenomenon, strabismus and amblyopia status were evaluated.

Results: The mean age of the patients was 9.05±4.18 years, and the follow-up period was 21.19±12.90 months. The etiology of ptosis was congenital myogenic in 49 (74.4%) patients, congenital neurogenic in 13 (19.6%) patients, and acquired in 4 (6%) patients. Strabismus was detected in 12 patients (18%), and amblyopia was detected in 35 eyes (44.9%). The most frequently used surgical techniques were frontal suspension with silicone (30.8%), müller muscle conjunctival resection (28.2%), and levator surgery (25.6%). Revision surgery was performed in 29 eyes (37.2%). The preoperative MRD-1 (0.72±1.26 mm) showed a significant increase at 6 months postoperatively (2.20±1.42 mm) (p<0.001). A positive correlation was found between final BCVA and preoperative BCVA (r=0.579, p<0.001). A low to moderate significant correlation was found between postoperative lagophthalmos and punctate staining (r=0.308, p=0.012). Lagophthalmos was more pronounced in the silicone sling group.

Conclusions: In pediatric ptosis surgery, a high rate of functional and aesthetic success is achieved through the selection of surgery appropriate to the etiology and careful postoperative follow-up.