Comparison of Postoperative Complications Before and After Implementation of a Care Protocol for Upper Eyelid Ptosis Surgery With Assessment of Patient Satisfaction and Compliance Following Protocol Use

Abstract

Background:
Upper eyelid ptosis is a common condition that affects both visual function and facial appearance, particularly in patients undergoing correction with the levator advancement technique. In the absence of standardized postoperative care guidelines, misunderstandings in self-care may occur, leading to an increased risk of postoperative complications and reduced patient satisfaction. Samutprakan Hospital therefore developed a written postoperative care protocol for patients undergoing ptosis correction surgery to ensure consistent and clear postoperative management.

Objective:
To compare postoperative complication rates, patient satisfaction, and adherence to postoperative instructions before and after implementation of the written postoperative care protocol.

Methods:
This comparative descriptive study included 80 patients diagnosed with upper eyelid ptosis who underwent correction using the levator advancement technique with a standardized surgical approach. Patients were divided into two groups: 40 patients treated before and 40 patients treated after protocol implementation. The postoperative care protocol consisted of written instructions regarding wound care, medication use, cold compress application, and postoperative follow-up. The protocol was explained to patients by the surgeon preoperatively and reinforced by nursing staff postoperatively. Data were analyzed using Chi-square test, Fisher’s exact test, and Independent t-test.

Results:
Postoperative complications were observed in 9 patients (22.5%) in the pre-protocol group, whereas no complications were reported in the post-protocol group. The overall patient satisfaction score increased from 4.0 to 4.5 (p < 0.001), and adherence to postoperative instructions improved from 8.3 to 9.5 (p < 0.001).

Conclusion:
The implementation of a written postoperative care protocol for patients undergoing upper eyelid ptosis correction surgery effectively reduced postoperative complications, improved adherence to postoperative instructions, and significantly increased patient satisfaction.