Serious corneal complication after ptosis surgery. Six case reports

Purpose: To assess the occurrence of serious corneal complications in ptosis surgery and identify their determining factors. Patients and methods: Retrospective study conducted on 3,500 patients over 20 years. All the clinical and etiological types of ptosis were treated in compliance with operative contra-indications. All four techniques of ptosis surgery were performed (anterior levator resection, the anterior levator aponeurotic approach, Muller's muscle shortening, and brow suspension). Data regarding serious corneal complications were collected using hospital patient records. Results: Six serious corneal complications were noted in four males and two females. Evisceration was necessary in two cases and prolonged hospital care in four cases, requiring occasional medial tarsorrhaphy surgery. Complications were observed in malformed congenital ptosis associated with an oculomotor disorder and in one case of congenital III paralysis. Young age seems to be a particular risk. Corneal complications can occur long after initial surgery, Predisposing factors were noted such as an associated oculomotor disorder, blepharoconjunctivitis, severe eye dryness, and specific working environments. Conclusion: Serious corneal complications in ptosis surgery are rare. However, a risk may occur long after initial surgery. Congenital malformation ptosis associated with oculomotor disorder seems to present a higher risk of corneal complication in combination with specific predisposing factors.