Ptosis Surgery in Patients with Myasthenia Gravis: A Useful Adjunct to Medical Therapy

ABSTRACT

Introduction: Medical management can have limitations in improving ptosis in patients with myasthenia gravis (MG). We present our experience of ptosis surgery in MG. Materials and Methods: Clinical records of all patients with MG undergoing ptosis surgery from September 2007 to November 2013 in a single center were retrospectively reviewed. Change in upper marginal reflex distance (uMRD) was the main outcome measure. Results: Sixteen external levator advancement (ELA) procedures were performed on 11 MG patients. Fourteen of 16 procedures had pre- and postoperative uMRD documented. Thirteen of 14 procedures had improved lid height; mean increase in uMRD was 2.4 mm (P=0.0005651). Two patients required secondary lid elevation. Postoperative complications included more noticeable diplopia (n=1) and exposure keratopathy (n=1). Conclusion: Ptosis surgery is a useful adjunct to medical therapy to improve lid height in MG patients with ptosis. Risks of diplopia and exposure keratopathy should be discussed with the patient pre-operatively.

Keywords:

• External levator advancement
• eyelid surgery
• myasthenia gravis
• ocular myasthenia
• ptosis

ACKNOWLEDGMENTS

The authors thank the staff in medical records in New Stobhill Hospital, Glasgow, UK, for retrieving the case notes.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.