A modification of swimmer plot for overviewing the postoperative longitudinal course.

Background: Long-term follow-up is essential for assessing the efficacy of surgical methods in pediatric patients. However, cohort dropouts tend to increase over time. These losses to follow-up make it difficult to obtain reliable and convincing results. The aim of this article is to present an easily understandable graphical method for visualizing the postoperative course using a cohort of patients with congenital blepharoptosis.

Methods: Patients with congenital blepharoptosis who underwent frontalis suspension were retrospectively reviewed. The postoperative courses of all the patients were illustrated using two modified swimmer plots to depict reoperation events. One plot used postoperative years as the x-axis, while the other used patients' ages. Each horizontal bar represented an individual patient, with reoperations indicated by changes in color.

Results: A total of 130 patients was included. The plot with postoperative years as the x-axis showed that most reoperations occurred >9 years after the initial surgery. The age-based plot showed that most secondary revision surgeries were performed between 10 and 20 years of age. The age distribution of reoperations followed an approximately sigmoidal curve, with a median age of 15.6 years. This distribution resembled the follow-up endpoints of patients who did not undergo reoperation.

Conclusions: A modified swimmer plot that includes all patients is a useful tool for visualizing longitudinal outcomes and identifying issues that may be overlooked with conventional analytical methods.