Purpose: To evaluate the demographics and outcomes of management for blepharoptosis associated with third cranial nerve palsy at a tertiary eye center.
Methods: This retrospective cross-sectional and interventional study was performed on hospital records of patients with ptosis associated with third cranial nerve palsy who were referred to Labbafinejad Medical Center from January 1999 to January 2009. The authors evaluated age, sex, laterality, severity of involvement, etiology, clinical findings, and treatment modalities and outcomes in patients with blepharoptosis due to third cranial nerve palsy over a 10-year period.
Results: Of a total of 45 subjects, 25 cases (55.6%) were males and 20 subjects (44.4%) were females. Mean age of enrolled subjects was 21.1 ± 15.5 years. Etiologies included trauma in 21 (46.7%), congenital in 16 (35.6%), and other causes in 8 (17.7%) cases. Overall, 18 of 45 patients (40%) underwent ptosis surgery: of these, 15 (83.3%) subjects improved with one procedure, whereas 3 (16.7%) subjects required more than one operation. For initial ptosis surgery, 5 (27.7%) patients underwent levator resection and 13 (72.3%) cases underwent frontalis sling; all second and third procedures were frontalis sling. One-step, 2-step, and 3-step ptosis surgery was accomplished in 15 (83.3%), 1 (5.6%), and 2 (11.1%) patients, respectively. Eventually, an open visual axis was attained in all cases following 1-3 operations.
Conclusions: Trauma was the most common cause of ptosis associated with third cranial nerve palsy in the current series. Surgical management of ptosis in patients with third nerve palsy may be challenging but most subjects achieve good results following appropriate and stepwise surgical plans.