title: Ptosis secondary to anterior segment surgery and its repair in a two-year follow-up study.
abstract: OBJECTIVE
  Aponeurotic blepharoptosis is a postoperative complication of anterior segment surgery with a reported incidence of 1-2% and a variable aetiology. In this 2-year follow-up study, we investigated the incidence of this postoperative complication in our experience of anterior segment surgery and propose a modified technique of aponeurosis advancement for its repair.
  
  
  METHODS
  200 consecutive patients undergoing anterior segment surgery in our eye clinic were enrolled in the study. Patients who developed any other operative or postoperative complication were excluded from the study. In all patients, the following upper lid parameters were calculated to determine whether postoperative blepharoptosis had occurred: margin-reflex distance, upper eyelid crease, use of frontalis muscle and levator function. A questionnaire was submitted to all blepharoptosis patients investigating mainly their subjective judgement of the impact of blepharoptosis on their quality of life and if they had been informed accurately about the incidence of this postoperative complication.
  
  
  RESULTS
  163 patients were included in our study. 11 had postoperative blepharoptosis (6.7%). 9 patients wanted ptosis repair and were operated on with our modified technique. None of the 11 ptosis patients had been informed about the possible occurrence of the blepharoptosis as postoperative complication. Our modified technique shows good, long-lasting results.
  
  
  CONCLUSIONS
  Postoperative blepharoptosis is a well-known postoperative complication of anterior segment surgery. It can be successfully treated surgically by aponeurosis advancement. It is our opinion that all patients should be informed of the possibility of postoperative blepharoptosis when consenting for anterior segment surgery.
authors.affiliation: Department of Neurological and Vision Sciences, Section of Ophthalmology, University of Genoa, Genoa, Italy. altieri.ferraris@tin.it
authors.forename: Michele
authors.initials: M
authors.lastname: Altieri
authors.forename: Eleanor
authors.initials: E
authors.lastname: Truscott
authors.forename: Amy E H
authors.initials: AE
authors.lastname: Kingston
authors.forename: Roberta
authors.initials: R
authors.lastname: Bertagno
authors.forename: Gianguido
authors.initials: G
authors.lastname: Altieri
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000601:surgery*; D001763:Blepharoptosis / Q000209:etiology* / Q000601:surgery; D016039:Corneal Transplantation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D018918:Phacoemulsification / Q000009:adverse effects; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D014130:Trabeculectomy / Q000009:adverse effects