This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.
An investigation to assess the effectiveness of the intraoperative lagophthalmos formula (IOLF) in levator resection for treatment of congenital ptosis shows high success and patient satisfaction. The prospective, single-center cohort study presented at the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, also identified preoperative conditions associated with superior outcomes.
The investigators examined 24 eyelids of 17 pediatric patients with congenital ptosis who underwent levator resection using IOLF. The IOLF tool allows for measurement of the intraoperative lagophthalmos with a caliper and adjustment of the central fixation suture level until the precalculated intraoperative lagophthalmos amount is attained. Clinical data collected included preoperative and postoperative assessment of margin to reflex distance 1 (MRD1) and levator function (LF). Assessment of surgical outcome was based on a postoperative MRD1 value of 3 mm or greater in each eye and a difference in MRD1 of 1 mm or less between eyes.
Results of the study indicated that when using IOLF calculations to guide levator resection, 87.5% (n=21) of patients had a satisfactory correction, while 8.3% (n=2) had an undercorrection and 4.2% (n=1) had an overcorrection. In assessing preoperative values, the researchers found that only MRD1 and LF were positively correlated with postoperative MRD1 (r=0.277, P =.022; and r=0.173, P =.038, respectively).
Additionally, preoperative MRD1 values of 0 mm and higher and an LF between 5 mm and 8 mm were significantly associated with satisfactory surgical outcome (Χ2 =4.681, P =.03; and Χ2=7.839, P =.005).
The researchers concluded that the IOLF calculation may be a useful tool to enable surgeons to predict the amount of ptosis correction needed in levator resection.
Han YE, Sa HS. Effectiveness of intraoperative lagophthalmos formula in levator resection for congenital ptosis. Poster presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.