Surgical repair reduces deficits and improves quality of life for patients with blepharoptosis

Blepharoptosis, also known as ptosis, is defined as an abnormal low-lying upper eyelid margin with the eye in primary gaze. Blepharoptosis causes substantial reduction in a patient's quality of life. The limitations resulting from this reduction may affect the patient's perceived general vision, peripheral vision and ability to drive.

A research team at Mayo Clinic in Rochester, Minn., examined the effects of blepharoptosis and its surgical repair on health-related quality of life using two validated response measures:

  • The 25-item National Eye Institute (NEI) Visual Functioning Questionnaire-25 (VFQ-25), a vision-specific instrument
  • The EuroQol Group's EQ-5D, a generic, health-related quality-of-life instrument

Mayo Clinic researchers found that surgical blepharoptosis repair was associated with statistically and clinically significant improvement in patient quality of life comparable in magnitude to what other investigators have reported for exudative age-related macular degeneration treatment with anti-vascular endothelial growth factor therapy.

The team conducted a prospective pre- and post-surgery survey analysis of 48 adults who underwent blepharoptosis surgery between March 2008 and March 2009. The study group participants were 32 women and 16 men who ranged in age from 43 to 87 years. Of the participants, 37 had bilateral and 11 had unilateral blepharoptosis repair under local anesthesia with sedation. The time between pre- and post-surgery surveys ranged from 14 to 252 days. An abstract of the study was presented at the annual meeting of The Association for Research in Vision and Ophthalmology in 2012.

Survey comparisons

The NEI VFQ-25 uses 25 subscale scores in 11 categories and generates an unweighted composite score that averages all visual activity scores. The EQ-5D assesses five health-related quality-of-life domains to generate index scores that correspond to related health states. The team used t-tests for paired data to compare both the NEI VFQ-25 subscale scores and composite scores and the EQ-5D index and overall quality-of-life scores.

Prior studies show that individual subscore changes of five or more points indicate clinically significant change. Clinically significant change for this study was set at an even more conservative 10 or more points. The EQ-5D showed statistically significant change in individual scores for usual activities, with a reduction in deficits reported across all dimensions.

For more information

Brach J, et al. Evaluating outcomes of blepharoptosis surgery through validated response measures. Presentation at: The Association for Research in Vision and Ophthalmology; 2012; Fort Lauderdale, Fla.

Points to remember

  • Blepharoptosis, also known as ptosis, is defined as an abnormal low-lying upper eyelid margin with the eye in primary gaze and may markedly affect a patient's quality of life due to reduction in vision.
  • A Mayo Clinic prospective pre- and post-surgery analysis of 48 adults showed that surgical blepharoptosis repair was associated with statistically and clinically significant improvement in patient quality of life.
Feb. 26, 2014