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Outcome Following Surgery for Contact Lens-Induced Ptosis

de Silva, D. Julian F.R.C.S., F.R.C.Ophth.; Collin, J. Richard O. F.R.C.S., F.R.C.Ophth., D.O.

Ophthalmic Plastic & Reconstructive Surgery: May-June 2011 - Volume 27 - Issue 3 - p 186-189
doi: 10.1097/IOP.0b013e318201cfcc
Original Investigations

Purpose: To assess the outcome of surgery in patients with a history of contact lens wear.

Design: 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.

Main Outcome Measures: 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.

There is an association of hard contact lens use and acquired involutional ptosis. In this study we found the severity of contact lens-related ptosis was related to the degree of myopia and patient age, but not duration of wear.

Moorfields Eye Hospital, London, United Kingdom

Accepted for publication February 13, 2010.

Address correspondence and reprint requests to Don Julian de Silva, F.R.C.S., F.R.C.Ophth., Oculoplastics Department, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. E-mail:

©2011The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.