DR MRITTIKA SEN

DR. SANTOSH G. HONAVAR

Abstract

Purpose: Clinical profile, surgical management and outcome in patients with aponeurotic ptosis (AP).

Methods: Retrospective interventional study of 154 eyes of 123 patients with AP over 7y. Outcome good: residual ptosis <1mm, MRD1>2mm, MRD1 asymmetry <1mm, with good lid contour. Results: AP constituted 123/847 (15%) of all ptosis. Mean age was 36.9+19.1y. AP was congenital in 41(33%), bilateral in 35 (23%). 124 (81%) had disinsertion, 12 (8%) had dehiscence, 20 (13%) had fatty degeneration. Preoperative PFH 6.5+1.7(2-10)mm, MRD1 0.2+1.5(-4-3)mm, levator action 12.2+2.8(6-20)mm. Skin approach aponeurosis repair included reinsertion 124 (81%), plication 11 (7%), resection 13 (8%), with suture adjustment 21 (14%) at a median of 7d. Postoperative PFH 9+1.2(5-12) mm, MRD1 2.6+1(-2 to 5)mm at mean follow-up 33+28 m, with good outcome in 137(89%). Conclusion: The patients with AP were relatively young, congenital form constituting 1/3rd. Anterior approach repair provides good outcome.