Ruijter, L.J.F. de (2017) Retrospective evaluation of surgical treatment of palpebral ptosis at the University Medical Centre Groningen :An overview and comparison of objective and patient reported outcome. thesis, Medicine.
Full text available on request.Abstract
BACKGROUND: Palpebral ptosis (PP) can be treated by levator reinsertion in case of dehiscence or by frontalis suspension, in case of absent levator function . Outcome analysis of treatment is necessary to test if the achieved results are comparable to those reported in the literature and to be able to improve preoperative counselling. OBJECTIVE: Evaluation of the objective and patient-reported surgical outcome of palpebral ptosis using reinsertion of the levator muscle (RL) or frontalis suspension surgery (FS). METHODS: Pre- and postoperative upper margin reflex distance (MRD1) of 54 patients operated at the University Medical Centre Groningen (UMCG) between 2006 and 2016 was compared using FACE-gram software from photographs. The Glasgow Benefit Inventory (GBI) questionnaire was used to evaluate patient-reported benefit. Data were additionally analysed in three surgical groups: single RL, multiple RL and (single or multiple) RL with additional FS. RESULTS: Overall median MRD1 improved significantly with 1.38 mm [0.62-2.75] after surgery resulting in good surgical outcome in 32.5% of cases. In 67.5% of cases the postoperative MRD1 did not approach the MRD1 of a normal eyelid. No significant difference was found in improvement of MRD1 between different surgical groups. The overall GBI score showed that 62.1% of patients experienced clinically relevant benefit from surgery. In 31.0% of patients clinically relevant change was reported, and 6.9% of patients experienced disadvantage from surgery. No significant determinants predicting the GBI score were found. No correlation between difference in MRD1 and GBI score was found. CONCLUSIONS: This retrospective observational study showed significant improvement in MRD1 and patient reported benefit after single RL surgery and after FS surgery. However, these objective and subjective results did not correlate, suggesting that not all clinically found differences improve the patient’s quality of life. Further research on a larger scale is needed to identify determinants of benefit in a patient’s life and to improve personalised advice to patients who consider surgery.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Werker, Prof. Dr. P.M.N and Department: Plastic Surgery, UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:02 |
| Last Modified: | 25 Jun 2020 11:02 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2256 |
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