Photo Credit: Mykola Syvak

The following is a summary of “Outcomes of a novel algorithm for levator muscle plication surgery in congenital blepharoptosis,” published in the January 2024 issue of Ophthalmology by Kotb et al.

Researchers conducted a retrospective study to evaluate the effectiveness of a new algorithm for determining levator muscle plication in congenital blepharoptosis surgery.

They involved 34 patients diagnosed with congenital ptosis who underwent levator muscle plication surgery (October 2021 and November 2022). Patients were split into two groups, Group A, the levator muscle plication amount was determined using a conventional formula [(ptosis amount × 3) + 9 mm for cases with good levator function or (ptosis amount × 3) + 11 mm for cases with fair levator function]. In Group B, a novel nomogram was used. The outcome of the conventional formula was adjusted by subtracting 4 mm if the calculated amount was ≥15 mm or subtracting 3 mm if it was <15 mm. Compared demographic data, baseline ptosis characteristics, and postoperative results at 1 week, 1 month, 3 months, and 6 months. The primary outcome measure was the postoperative Marginal Reflex Distance (MRD1). Secondary outcome measures included lid contour, lid crease, and any reported complications.

The results showed that Group A comprised 20 eyes (18 patients), while Group B comprised 20 eyes (16 patients). The mean levator muscle plication amounts were 16.98 ± 2.44 mm and 13.48 ± 2.42 mm in Group A and B, respectively. The disparity between the two groups was highly statistically significant (P<0.001). In the 1st postoperative week, the mean MRD1 was 4.95 ± 0.37 mm in Group A and 4.08 ± 0.64 mm in Group B, with a statistically significant difference (P<0.001). Overcorrection was observed in 8 (40%) eyes in Group A and 1 (5%) eye in Group B, a statistically significant difference (P=0.008). Only 1 (5%) eye in Group B exhibited under correction. No other complications were reported. Surgical success was obtained in 12 (60%) eyes in Group A compared to 18 (90%) eyes in Group B, with a statistically significant difference (P=0.03).

Investigators concluded that the novel nomogram for calculating levator muscle plication in congenital blepharoptosis surgery effectively achieves satisfactory postoperative MRD1.

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03287-y