FACTORS PREDICTING THE OUTCOME OF ANTERIOR LEVATOR RESECTION IN CONGENITAL PTOSIS

Objective: To identify any consistent factors which may predict over or under correction of congenital ptosis treated by anterior levator resection Material and Methods: The study was conducted at Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar from January 1st 2006- December 31st 2006. The study was approved by the ethical committee of KIOMS A retrospective case note review of 50 consecutive patients undergoing anterior levator resection for congenital ptosis was performed to identify 1. The amount of ptosis and degree of levator function present pre-operatively and 2. The surgical outcome. For unilateral ptosis, a successful result was defined as a lid level within 1mm of the fellow lid following a single operation. Results: Fifty four eyelids of 50 patients (35 males and 15 females) with congenital ptosis were included in the study. Seventy seven percent (77.27%) of all unilateral patients had a successful outcome at 6 weeks following surgery, falling slightly to (73.52%) by 6 months. The most common complications at 6 months for all cases were under correction (20%) and over correction (7.5%). All patient under corrected at 6 months had pre-operative levator function in the range of 4-10 mm with a mean of 6.4 mm, whereas all those over corrected at 6 months had a levator function in the range of 9-15 mm with a mean of 12.2 mm. The degree of levator function was a predictor of increased risk of over correction, with a trend towards predicting under correction as well. Conclusion: In this series of patients, pre operative levator function was found to be the most significant predictor of surgical outcome for anterior levator resection