Comparative study of the subjective and objective grading of ptosis surgery outcomes

Abstract

Aims: To assess the results of blepharoptosis surgery in our hospital by subjective and objective grading of the outcome and comparing them to determine their degree of corelation. Methods: Retrospective interventional case series report supplemented by postal questionnaires and telephonic patient surveys. The study included 107 eyelids of 78 patients. Using a simple grading system, surgical outcome was objectively graded as good, suboptimal, or poor. Outcome was also defined according to the patients' perspective as good, suboptimal, or poor. Level of agreement between the subjective and objective grading of the outcome was measured using a weighted kappa analysis. Results: The objective results were classed as good - 68/107 (63.5%), suboptimal - 18 eyelids (16.8%), and poor - 21 eyelids (19.6%). The subjective results were obtainable in 91 eyelids and were good - 54/91 (59.3%), suboptimal - 8/91 (8.7%), and poor - 29/91 (32%). A mismatch between objective and subjective outcomes was seen in 16 eyelids. We saw a statistically significant corelation between the objective grading and the patients' perspective (P<0.001). Conclusion: Our overall ptosis surgery results are comparable with rates previously reported. The subjective and objective outcomes of ptosis surgery may sometimes vary, but nevertheless exhibit substantive agreement when measured by this simple grading system.