Incidence and risk of ptosis following ocular surgery: a systematic review and meta-analysis

Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):397-404. doi: 10.1007/s00417-018-4130-6. Epub 2018 Sep 10.

Abstract

Objective: We conducted a systematic review and meta-analysis to evaluate the incidence and risk factors of ptosis following ocular surgery.

Methods: PubMed, Embase, and Cochrane Library were searched for articles that assessed the incidence or risk factors of ptosis following ocular surgery up to October 2017. We used a fixed effects model to calculate a pooled estimate of incidence, with subgroup analyses to evaluate the effect of different variables. The relative risks (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) for all available factors were calculated using the fixed effects models.

Results: A total of 16 studies on 2856 eyes were analyzed, including 3 randomized controlled trials (RCTs) and 13 cohort studies. The overall incidence of ptosis following ocular surgery was 11.4% (95% CI 10.1-12.8%). Subgroup analyses showed that the region and the surgery type were significantly associated with the incidence of postoperative ptosis. Men were less likely to get postoperative ptosis than women (OR 0.62; 95% CI 0.43-0.89). However, age (OR 0.77; 95% CI 0.48-1.23), side (OR 1.37; 95% CI 0.84-2.25), type of anesthesia (OR 0.57; 95% CI 0.16-2.05), prior surgery (OR 1.09; 95% CI 0.64-1.83), bridle suture (OR 2.04; 95% CI 0.94-4.42), or combined surgery (OR 0.95; 95% CI 0.58-1.57) did not significantly change the risk of ptosis following ocular surgery.

Conclusion: More than one in ten patients who undergo ocular surgery will develop ptosis. Different regions and surgery types may influence the occurrence of this abnormality. Female gender is a risk factor for development of postoperative ptosis.

Keywords: Incidence; Meta-analysis; Ocular surgery; Ptosis; Risk factor.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blepharoptosis / epidemiology*
  • Blepharoptosis / etiology
  • Global Health
  • Humans
  • Incidence
  • Ophthalmologic Surgical Procedures / adverse effects*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Risk Assessment*
  • Risk Factors