Postcataract Ptosis

Feibel, Robert M.; Custer, Philip L.; Gordon, Mae O.

doi:10.1016/s0161-6420(93)31592-7

Cited by 50 publications

(12 citation statements)

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“…Altieri et al 9 found that ptosis occurred in 4 of 97 eyes (4%) that underwent phacoemulsification and intraocular lens implantation compared with 1 in 13 eyes (8%) that underwent trabeculectomy (no statistical comparison). Other studies also reported that postoperative ptosis occurred after cataract surgery at rates ranging from 5% to 14%, 12 – 15 and the surgeries in these studies used larger incisions and regional anesthesia. The frequency of ptosis is expected to be even lower in recent cataract surgeries, which use small incisions under topical anesthesia.…”

Section: Discussionmentioning

confidence: 95%

Incidence of Postoperative Ptosis Following Trabeculectomy With Mitomycin C

Naruo-Tsuchisaka

Maruyama

Arimoto

et al. 2015

Journal of Glaucoma

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Purpose:To prospectively investigate the incidence of postoperative ptosis following trabeculectomy by comparing preoperative and postoperative margin reflex distance (MRD), and to analyze the clinical factors associated with ptosis.Patients and Methods:Patients who underwent trabeculectomy with mitomycin C in unilateral eye between 2010 and 2012 were enrolled. MRD was measured before and 3 and 6 months after trabeculectomy. The MRD is the distance between the light reflex at central cornea and the upper eyelid margin when the patient gazed at a pen light placed 50 cm away straightly. Postoperative ptosis was defined as a decrease in MRD≥2 mm from preoperative level. The correlation among ΔMRD (difference between preoperative and 6 mo postoperative MRD) and clinical factors comprising age, spherical equivalent, preoperative MRD, 6-month postoperative intraocular pressure (IOP), and IOP reduction (difference between preoperative and 6 mo postoperative IOP) was analyzed.Results:Thirty-six patients (36 eyes) were analyzed. Preoperative median MRD was not different between the operated eye and nonoperated fellow eye (both 4.0 mm, P=0.65). The 3- and 6-month postoperative MRD in the operated eye were significantly reduced compared with preoperative MRD (3.0 mm, P=0.04 and 2.5 mm, P=0.01, respectively). The 3- and 6-month postoperative MRD in the nonoperated eye were not different from preoperative MRD (4.0 mm, P=0.81 and 4.0 mm, P=0.85, respectively). The incidence of ptosis at 6 months after operation was 19% (7 of 36 eyes). The IOP was significantly decreased at 3 and 6 months after operation (both P<0.01). No correlation was observed between ΔMRD and all the factors analyzed.Conclusions:Ptosis is a major complication following trabeculectomy with mitomycin C, with an incidence of 19% at 6 months after operation.

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Section: Discussionmentioning

confidence: 95%

Incidence of Postoperative Ptosis Following Trabeculectomy With Mitomycin C

Naruo-Tsuchisaka

Maruyama

Arimoto

et al. 2015

Journal of Glaucoma

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“…Today, local anesthesia is being used for most of vitreoretinal surgical procedures. As known, many complications have been reported with injection anesthesia, including globe perforation [14–16], injury to optic nerve [17], cranial nerve palsies [18], restrictive strabismus [19], diplopia [20], ptosis [21], retinal vein and artery occlusion [22, 23], and seizures and cardiorespiratory arrest [24, 25]. Mahajan et al reported that injection delivered in wrong plane can present as significant conjunctival chemosis, which ultimately hinders conjunctival displacement and later conjunctival migration for sutureless port closure [13].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Çeliker

Karabaş

Şahin

2014

Journal of Ophthalmology

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Background. To compare the efficacy and safety of topical anesthesia versus retrobulbar anesthesia in 23-gauge vitreoretinal surgery. Materials and Methods. A total of 63 patients scheduled for 23 G posterior vitrectomy without scleral buckling procedures were included in the study. The patients were randomly assigned to receive either topical (Group 1, n = 31) or retrobulbar anesthesia (Group 2, n = 32). Postoperatively, patients were shown a visual analogue pain scale (VAPS) from 1 (no pain or discomfort) to 4 (severe pain or discomfort) to rate the levels of pain. Results. There was more discomfort in patients in Group 2 while anesthetic was administered (Group 1: 1.0 ± 0, Group 2: 2.3 ± 0.7, P = 0.0001). Between the two groups the level of pain during surgery (Group 1: 1.4 ± 0.5, Group 2: 1.5 ± 0.5; P = 0.85) was noted. There was also no significant difference between two groups postoperatively (Group 1: 1.2 ± 0.4, Group 2: 1.3 ± 0.4; P = 0.28). There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period. Conclusion. Topical anesthesia in posterior vitrectomy procedures is an effective and safe method that is alternative to retrobulbar anesthesia.

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“…The incidence of ptosis after cataract surgery alone has been reported to be between 5% and 20%. [ 1 2 3 ] Postoperative ptosis can be classified into transient or persistent and is mostly traumatic in nature. The true incidence of postoperative ptosis could be underestimated because a substantial proportion of postoperative ptosis resolves after 6 months and only around 18% of patients noticed a change in their upper eyelid position after cataract surgery.…”

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confidence: 99%

“…The true incidence of postoperative ptosis could be underestimated because a substantial proportion of postoperative ptosis resolves after 6 months and only around 18% of patients noticed a change in their upper eyelid position after cataract surgery. [ 3 ] However, the incidence of ptosis after combined phacotrabeculectomy with mitomycin C is not known in Asian eyes. The risk of postoperative ptosis was shown to be associated with several risk factors such as longer surgery resulting in prolonged eyelid compression from lid speculum, prolonged eyelid edema from periocular inflammation, and foreign body reaction from conjunctival sutures.…”

mentioning

confidence: 99%

Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification

Koh

Tatsios

Chew

et al. 2015

Indian J Ophthalmol

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Objective:To compare the incidence of upper eyelid blepharoptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification surgeries and the relationship of bleb morphology to the incidence of ptosis.Design:Retrospective observation study.Participants:We included 46 patients after combined phacotrabeculectomy and 44 patients with phacoemulsification in the former group, and all eyes underwent a standardized two-site surgery with intra-operative mitomycin C.Materials and Methods:Postoperative ptosis was defined as a reduction of upper marginal reflex distance 2 mm in the operated eye compared to the fellow eye. Trabeculectomy bleb measurements were carried out using anterior segment optical coherence tomography (VisanteTM, Carl Zeiss Meditec, Dublin, CA, USA) which included bleb height and total area of the bleb.Results:There were 8 eyes (17.4%) and 5 eyes (11.4%) with postoperative ptosis in the phacotrabeculectomy and phacoemulsification groups, respectively (P = 0.342). In multivariate regression analysis, reduced total bleb area was significantly associated with upper eyelid ptosis after adjusting for age, gender, and type of anesthesia. The trend seemed to show that increased bleb height was also associated with ptosis, but this did not reach statistical significance.Conclusions:Incidence of persistent ptosis after phacoemulsification combined with trabeculectomy and mitomycin C is similar compared to stand alone phacoemulsification surgery in a multiethnic Asian population. Bleb morphology may play an important role in postoperative ptosis development and should be considered in the evaluation of upper eyelid blepharoptosis.

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Postcataract Ptosis

Cited by 50 publications

References 10 publications

Incidence of Postoperative Ptosis Following Trabeculectomy With Mitomycin C

Incidence of Postoperative Ptosis Following Trabeculectomy With Mitomycin C

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification

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