METHOD: This case series report includes all 19 consecutive cases presenting to the Chang Gung Craniofacial Center for combined orthognathic surgery with Asian double eyelid suture method blepharoplasty. The double eyelid crease height was measured as the vertical line between the upper eyelid margin (eyelid lash) and the upper eyelid crease, observed at the mid-pupillary line with the eyes in primary gaze.
RESULTS: There were no complications or relapse reported within this time period. There was significant improvement in the left and right mid-pupillary double eyelid crease height postsurgery. There were no statistically significant differences between the left and right mid-pupillary double eyelid crease heights after surgery indicating good eyelid crease height symmetry bilaterally was obtained.
CONCLUSIONS: Orthognathic surgery combined with suture method blepharoplasty can be safely performed in the same surgical setting without inappropriate rise in costs or operating room time. This case series demonstrates that excellent esthetic results can be obtained in simultaneous bimaxillary orthognathic surgery with suture method Asian blepharoplasty.
METHODS: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children's Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery.
RESULTS: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001).
CONCLUSIONS: Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.