an article about optimal age for surgical correction of BPES

February 18, 2004

This article was published back in April 2003. Again, it is from PubMed.

Shireen

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Clin Experiment Ophthalmol. 2003 Apr;31(2):138-42. Related Articles, Links

Blepharophimosis: a recommendation for early surgery in patients with severe

ptosis.

Beckingsale PS, Sullivan TJ, Wong VA, Oley C.

Eyelid, Lacrimal and Orbital Clinic, Royal Children's Hospital, Brisbane,

Queensland, Australia.

PURPOSE: To determine the optimal age for surgical correction of

blepharophimosis. Associated features and their effects on incidence of

amblyopia were also investigated. METHODS: The study was a retrospective

case series of 28 patients with blepharophimosis, ptosis and epicanthus

inversus syndrome presenting to a tertiary referral eyelid, lacrimal and

orbital clinic. RESULTS: Amblyopia was present in 39% of patients. Patients

with coexistent strabismus had a 64% incidence of amblyopia compared to 24%

for those without strabismus. Hypermetropia was present in 43% of patients

and 7% were myopic. Significant astigmatism was found in 40% of patients,

but these factors did not increase the risk of amblyopia. Patients with

severe ptosis had lower rates of amblyopia than those with moderate ptosis

but had their ptosis corrected at a median age of 2 years compared to 5

years for those with moderate ptosis. There was an 18% incidence of

nasolacrimal drainage problems. A good to excellent cosmetic outcome was

achieved in 86% of patients. A positive family history was noted in 75% of

patients, usually with paternal inheritance. CONCLUSIONS: Patients with

blepharophimosis have a high rate of amblyopia. Co-existent strabismus

doubles the risk of amblyopia. Ptosis alone causes mild to moderate

amblyopia only. Patients with severe ptosis should have their ptosis

corrected before 3 years of age, and all other patients should undergo

surgery before 5 years of age.

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