Blepharoptosis in Indonesia: a 5-year retrospective cross-sectional multicenter study on characteristics and surgical evaluation

Introduction: This study addresses the lack of data on blepharoptosis prevalence in Indonesia, aiming to analyze cases in national referral hospitals for improved clinical decisions and preventive strategies. Methods: This is a cross-sectional, retrospective, multicentered study involving 823 patients from 10 Indonesian tertiary hospitals. Data from January 2016 to December 2020 were collected, focusing on patient demographics, blepharoptosis classifications, and surgical outcomes. The study analyzes surgical methods, satisfaction rates, and complications. Primary outcomes involve surgical satisfaction, while secondary outcomes include complications such as recurrence, under/overcorrection, and asymmetry. Results: The study involved 823 patients from 11 Indonesian hospitals, mostly females (54.8%). Acquired blepharoptosis (54.7%), unilateral cases (83.2%), and severe forms (62.1%) were common. Myogenic mechanism prevailed (47.0%). Surgery on 705 eyes used mainly levator resection (61.7%). Surgical outcomes were unsatisfactory in 57.7%, influenced by age above 40 years (OR: 2.510, P<0.0001), acquired ptosis (OR: 2.359, P<0.0001), levator resection technique (OR: 1.789, P=0.002), and levator function (poor OR: 1.963, P=0.021; fair OR: 0.372, P<0.0001) in multivariate analysis. Conclusion: The study emphasizes factors influencing negative outcomes in ptosis correction and suggests the need for more research to enhance surgical techniques and improve patient satisfaction and long-term results.