Ptosis Surgery in Patients with Myasthenia Gravis: A Useful Adjunct to Medical Therapy. (3rd April 2018)

• Record Type: Journal Article
• Authors: Brogan, Kerr; Farrugia, Maria E.; Crofts, Kevin
• Is Part Of: Seminars in ophthalmology. Volume 33:Number 3(2018)
• Page Start: 429
• Page End: 434
• Publication Date: 2018-04-03
• Subjects: External levator advancement -- eyelid surgery -- myasthenia gravis -- ocular myasthenia -- ptosis; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Eye -- Surgery -- Periodicals; 617.7005
• DOI: 10.1080/08820538.2017.1284871
• Languages: English
• ISSNs: 0882-0538

Abstract

ABSTRACT: Introduction : Medical management can have limitations in improving ptosis in patients with myasthenia gravis (MG). We present our experience of ptosis surgery in MG. Materials and Methods : Clinical records of all patients with MG undergoing ptosis surgery from September 2007 to November 2013 in a single center were retrospectively reviewed. Change in upper marginal reflex distance (uMRD) was the main outcome measure. Results : Sixteen external levator advancement (ELA) procedures were performed on 11 MG patients. Fourteen of 16 procedures had pre- and postoperative uMRD documented. Thirteen of 14 procedures had improved lid height; mean increase in uMRD was 2.4 mm ( P =0.0005651). Two patients required secondary lid elevation. Postoperative complications included more noticeable diplopia (n=1) and exposure keratopathy (n=1). Conclusion : Ptosis surgery is a useful adjunct to medical therapy to improve lid height in MG patients with ptosis. Risks of diplopia and exposure keratopathy should be discussed with the patient pre-operatively.