Outcome following surgery for contact lens-induced ptosis.

PURPOSE To assess the outcome of surgery in patients with a history of contact lens wear. DESIGN Retrospective, comparative interventional case series. METHODS A total of 419 patients underwent ptosis surgery during a 1-year period (2005-2006) at Moorfields Eye Hospital. Those included in this study had a diagnosis of aponeurotic ptosis and history of contact lens wear. MAIN OUTCOME MEASURES The outcome was considered a success if the following criteria were met: 1) a margin reflex distance of between 3 and 5 mm, 2) an interlid difference of 1 mm or less, and 3) absence of redo surgery. RESULTS Thirty patients (7.2%) were identified with a history of contact lens wear and were matched against a control group of 46 patients. The mean margin-reflex distance at presentation was 0.5 ± 2.4 mm. This equated to a ptosis graded as mild (≥1.5 mm) for 32% of patients, moderate (0.5-1.0 mm) for 29%, and severe (≤0.0 mm) for 39%, with similar proportions in the control group (36% mild, 39% moderate, and 25% severe). The power of the refractive correction (p < 0.005) and the age of the patient (p < 0.05) were directly related to increased severity of ptosis at presentation. The surgical outcome of the ptosis correction was successful in 72% of patients, which was significantly lower than in the control group (89%) (p < 0.005). CONCLUSIONS The severity of contact lens-related ptosis was related to the degree of myopia and the age of the patient but not to the duration of contact lens wear. There was a higher level of failure and requirement for redo surgery in patients with contact lens-related ptosis compared with matched controls.