Classification of Ptosis in Korea

ABSTRACT

PURPOSE: To classify blepharoptosis in Korean patients, investigate the type of surgery used, and to compare the results with the data from Western countries. METHODS: A total of 913 patients (1147 eyes) who underwent surgery for blepharoptosis from 1991 to 2003 were classified as either being congenital or acquired blepharoptosis, and then further subclassified into myogenic, aponeurotic, mechanical, or neurogenic ptosis according to Freuh's mechanistic classification. The type of surgery for each type of blepharoptosis was investigated. RESULTS: Of the 913 patients, 695 (76.1%) were congenital type, and 218 (23.9%) were acquired type. Freuh's mechanistic classification by type was 84.7% myogenic type, 10.5% aponeurotic, 3.4% neurogenic, and 1.6% mechanical. By order of frequency, the type of surgery used was 60% frontalis suspension, 26.4% levator resection, 12.2% aponeurosis repair, and 1.4% conjunctivomullerectomy. CONCLUSIONS: Congenital type was more common than acquired type. The proportion of congenital type was higher than the results reported from Western countries, but lower than those of previous Korean studies. This is probably due to the increased number of adults undergoing surgery for blepharoptosis compared to the past, and is a reflection of influence of socio-economic levels.