title: Outcome following surgery for contact lens-induced ptosis.
abstract: OBJECTIVE
  To assess the outcome of surgery in patients with a history of contact lens wear.
  
  
  METHODS
  Retrospective, comparative interventional case series.
  
  
  METHODS
  A total of 419 patients underwent ptosis surgery during a 1-year period (2005-2006) at Moorfields Eye Hospital. Those included in this study had a diagnosis of aponeurotic ptosis and history of contact lens wear.
  
  
  METHODS
  The outcome was considered a success if the following criteria were met: 1) a margin reflex distance of between 3 and 5 mm, 2) an interlid difference of 1 mm or less, and 3) absence of redo surgery.
  
  
  RESULTS
  Thirty patients (7.2%) were identified with a history of contact lens wear and were matched against a control group of 46 patients. The mean margin-reflex distance at presentation was 0.5 ± 2.4 mm. This equated to a ptosis graded as mild (≥1.5 mm) for 32% of patients, moderate (0.5-1.0 mm) for 29%, and severe (≤0.0 mm) for 39%, with similar proportions in the control group (36% mild, 39% moderate, and 25% severe). The power of the refractive correction (p < 0.005) and the age of the patient (p < 0.05) were directly related to increased severity of ptosis at presentation. The surgical outcome of the ptosis correction was successful in 72% of patients, which was significantly lower than in the control group (89%) (p < 0.005).
  
  
  CONCLUSIONS
  The severity of contact lens-related ptosis was related to the degree of myopia and the age of the patient but not to the duration of contact lens wear. There was a higher level of failure and requirement for redo surgery in patients with contact lens-related ptosis compared with matched controls.
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom. drdjdesilva@yahoo.co.uk
authors.forename: D Julian
authors.initials: DJ
authors.lastname: de Silva
authors.forename: J Richard O
authors.initials: JR
authors.lastname: Collin
mesh_terms: D000328:Adult; D000368:Aged; D001763:Blepharoptosis / Q000209:etiology / Q000601:surgery*; D003261:Contact Lenses / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult