{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:01:45Z","timestamp":1791331305128,"version":"4.3.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine possible complications and efficacy of ptosis surgery in a series of chronic progressive external ophthalmoplegia (CPEO) patients with healthy tear film.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>It is a prospective interventional study on 24 eyes from 12 patients with the diagnosis of CPEO and ptosis. Pre-operatively, tear breakup test (TBUT) and Schirmer test were performed to assess lacrimal function unit. Levator resection was performed for 16 eyes with levator function (LF) more than 4\u2009mm, while eight eyes from four patients with poorer LF underwent frontalis silicone sling surgery. Main outcome measures included change in marginal-to-reflex distance (MRD1) and incidence of post-operative exposure keratopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean age of the patients was 45\u2009\u00b1\u200915\u2009years. The mean of TBUT and Schirmer test were 12\u2009\u00b1\u20091.98\u2009s and 15\u2009\u00b1\u20092.76\u2009mm, respectively. The mean follow-up period was 34\u2009months. Four eyes encountered mild to moderate exposure keratopathy. All cases were managed medically, with no need for surgical revision. The mean pre-operative MRD1, LF, and chin-up angle were \u22120.54\u2009\u00b1\u20091.03\u2009mm, 4.21\u2009\u00b1\u20091.41\u2009mm, and 21.6\u2009\u00b1\u20096.01\u2009degrees, respectively. The mean post-operative MRD1, LF, and chin-up angle were 2.42\u2009\u00b1\u20090.60, 4.46\u2009\u00b1\u20091.53\u2009mm, and 3.3\u2009\u00b1\u20091.01\u2009degrees, respectively. At 1-year follow-up visit, improvement in MRD1 and chin-up posture was statistically significant ( p-value\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Normal TBUT and Schirmer test results, prophylactic lubricating therapy, and close follow-up can be as important as Bell\u2019s phenomenon and palpebral fissure height in predicting post-operative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120672120952344","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T03:46:01Z","timestamp":1598499961000},"page":"2064-2068","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Surgical management of ptosis in chronic progressive external 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