One-stage versus two-stage surgical correction of blepharophimosis-ptosis-epicanthus inversus syndrome: a retrospective comparative study.

PURPOSE: To compare the surgical outcomes of one-stage and two-stage correction of blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) in children <3 years of age.

METHODS

This retrospective comparative study included children <3 years with BPES who underwent surgical correction at Cairo University. Medial canthoplasty was performed using the Y-V, C-U, or five-flap technique, while ptosis was corrected by frontalis suspension using polytetrafluoroethylene sling. Patients were divided into one-stage and two-stage groups. Surgical outcomes were assessed based on horizontal palpebral fissure length (HPFL), interpalpebral fissure height (IPFH), inner intercanthal distance (IICD) and IICD/HPFL ratio.

RESULTS

Twenty-four patients were included: 11 in the one-stage group and 13 in the two-stage group. Both groups showed significant postoperative improvements in HPFL, IPFH, IICD and IICD/HPFL (P < 0.005), with no statistically significant difference between them. The two-stage group had a higher proportion of patients with good blepharophimosis outcome (46% vs 27%), whereas the one-stage group showed a higher proportion of good ptosis outcomes (64% vs 46%); however, these differences were not statistically significant. Complications were minimal and comparable between both groups.

CONCLUSIONS

Outcomes of one- and two-stage approaches were comparable in our cohort. One-stage correction may be preferable in patients with severe ptosis, although two-stage repair may better address severe blepharophimosis.