PTOSIS -TYPES AND OPERATIONS FOR CORRECTION

Abstract

Objective: To analyze the management of different types of ptosis of upper eyelid.
Design: Descriptive Study.
Place and Duration of Study: Eye department CMH Kharian, From January 2006 to December 2007
Patients and Methods: Thirty six patients having ptosis of upper eyelid, managed in eye department, were analyzed to find out frequency of different types of ptosis. Fifteen patients (27 eyes) were managed surgically and the rest were managed medically. Results and complications of different procedures required for the surgical correction were also analyzed.
Results: Twenty (55.6%) were congenital and 16 (44.4%) were acquired. Eight (22.2%) patients had neurogenic ptosis, 5(13.9%) had mechanical ptosis, 17 (47.2%) cases had myogenic, 6 (16.7 %) had aponeurotic ptosis. Twenty seven eye of fifteen patients were managed surgically. The procedures performed, included levator resection, which was done in 18 (66.7%) eyes, frontalis suspension done in 8 (29.6%) eyes, conjunctivomuller resection in one (3.7 %) eye which had unilateral Horner’s syndrome. Post operative complications occurred in 4 (14.8%) eyes requiring reoperation. These included development of exposure keratopathy due to dryness of eyes in both eyes of one patient, overcorrection in one eye of a patient and undercorrection with hypotrpia in one eye of another patient. All achieved good results.
Conclusion: Different types of ptosis should be identified. Levator resection and frontalis suspension can effectively correct the ptosis in most of the cases. Complications of the surgery are infrequent.