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

Koh, Victor; Tatsios, Janina; Chew, Paul; Amrith, Shantha

doi:10.4103/0301-4738.176032

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…In the study of Song’s et al 11 , ptosis developed more often after combined glaucoma and cataract surgeries than after trabeculectomy alone (12.7% vs. 10.7%), which might be associated with different durations of the procedures. Similar results were also reported by Koh et al 17 . In our study, the mean operative time did not differ significantly between the groups, and hence, was unlikely to affect the outcome of the treatment.…”

Section: Discussionsupporting

confidence: 92%

A prospective, randomised study of the effect of fixation sutures during phacotrabeculectomy on intraocular pressure and incidence of ptosis

Konopińska

Lisowski

Mariak

et al. 2021

Sci Rep

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We investigated the effects of different intraoperative eyeball fixation techniques (superior rectus muscle suture [MS] and traction suture at the corneal limbus [CS]), on intraocular pressure (IOP) and the incidence of ptosis after phacotrabeculectomy. Forty-one eyes with different glaucoma types which qualified for phacotrabeculectomy were included. Twenty-three and eighteen patients were included in the CS and MS groups, respectively. The IOP, best-corrected visual acuity (BCVA), and margin reflex distance were assessed preoperatively and 3, 6, and 12 months post-operatively. Preoperatively, the mean IOPs (± standard deviation) in the CS and MS groups were 23.6 ± 7.3 mmHg and 24.3 ± 6.6 mmHg (p > 0.05), respectively. At 3 and 6 months post-surgery, the mean IOPs were significantly lower in the CS group than in the MS group: 13.9 ± 3.0 mmHg vs. 17.7 ± 3.5 mmHg (p = 0.001), and 13.9 ± 4.9 mmHg vs. 17.2 ± 3.5 mmHg (p = 0.005), respectively (mean difference: 3.9, 95% confidence interval 1.7–6.1). At 12 months, the mean postoperative IOPs were 15.2 ± 3.5 mmHg and 14.9 ± 3.6 mmHg in the CS and MS groups, respectively (p > 0.05). At 6 months, the BCVAs were 0.91 ± 0.15 and 0.71 ± 0.3 (p = 0.029) in the CS and MS groups, respectively; BCVAs were 0.91 ± 0.15 and 0.71 ± 0.3 (p = 0.029) in the CS and MS groups, respectively; the difference was non-significant 12 months post-surgery (0.78 ± 0.32 vs. 0.74 ± 0.30, p = 0.553). Postoperative ptosis was observed in 4 (17%) and zero patients in the CS and MS groups, respectively, but the difference was not statistically significant (p = 0.118). The study was not powered sufficiently to detect statistically significant changes in exploratory endpoints. The study was not powered sufficiently to detect statistically significant differences between groups in exploratory endpoints.

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Section: Discussionsupporting

confidence: 92%

A prospective, randomised study of the effect of fixation sutures during phacotrabeculectomy on intraocular pressure and incidence of ptosis

Konopińska

Lisowski

Mariak

et al. 2021

Sci Rep

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“…We believe that the methods used in our study can be considered reliable, easy to reproduce, and an optimum method to quantify and objectively compare the lower lid position than manual measurement used in previous studies. 5 10 11 12 13 Objective evaluation offers reliable measurements and follow-up of the very mild lower lid changes.…”

Section: Discussionmentioning

confidence: 99%

Changes in lower lid position after standard phacoemulsification cataract surgery

et al. 2020

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Purpose: To evaluate the changes on the position of the lower lid after phacoemulsification surgery using objective methods. Methods: This prospective study evaluated the lower lid position of cataract carriers who underwent to phacoemulsification surgery from January to May 2017. Data were collected on demographics, type of anesthesia, duration of the surgical procedure, and duration of the speculum remained in place. Standardized digital photographs of the patient's face in primary gaze position were obtained preoperatively and 1, 30, 90, and 180 days, postoperatively. The data were analyzed on the distraction test, distance of the lower lacrimal punctum from the inner canthus, and margin reflex distance 2 (MRD2). Comparative and correlation statistical analyses involving preoperative and postoperative measurements were performed. Results: One hundred twelve cataract patients comprised the study sample. There were 68 (60.7%) females with a median age of 74 (interquartile range, 70–81) years old. The mean distraction test value before surgery was 7 ± 2 mm and 6.8 ± 1.8 mm 180 days postoperatively ( P = 0.02). The mean lacrimal lower punctum distance changed from 5 ± 1.1 mm preoperatively to 5.4 ± 1 mm at 180 days postoperatively ( P = 0.06). The mean MRD2 preoperatively was 5 ± 1 mm and increased to 5.4 ± 0.9 mm 180 days after surgery ( P = 0.02). The duration of surgery and the duration that speculum remained in place were not correlated to MRD2 ( P = 0.7; P = 0.98). Conclusions: There is a mild lower lid laxity after phacoemulsification reflected by slight increased lacrimal lower punctum distance to the inner canthus and MRD2. Lacrimal lower punctum distance and MRD2 vary along the study and remained altered at 180 days after surgery, while distraction test tends to recover to similar preoperative levels. Although lid laxity is common in elderly cataract carriers, even a short procedure as phacoemulsification can mildly increase flaccidity.

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“…B lepharoptosis after intraocular surgeries has been a potential complication after ocular surgeries. [1][2][3][4][5][6][7][8][9][10][11][12] While the majority of them improve with no further intervention in the first few months (1-3 months) after the surgery (transient ptosis), a fraction of them might persist after 6 months which is called persistent ptosis. 2,12 Its frequency has been from 3% to 33% in different study designs, criteria, and surgical techniques.…”

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confidence: 99%

“…2,12 Its frequency has been from 3% to 33% in different study designs, criteria, and surgical techniques. [3][4][5][6][7][8][9][10][11][12] Cataract surgery resulted in less frequency of postoperative ptosis than glaucoma surgery. 3 The persistent postoperative ptosis has been reported as many as 3%-49% after extracapsular cataract extraction [4][5][6] and 12%-19% after glaucoma surgeries.…”

mentioning

confidence: 99%

“…3 The persistent postoperative ptosis has been reported as many as 3%-49% after extracapsular cataract extraction [4][5][6] and 12%-19% after glaucoma surgeries. 4,[7][8][9][10] However, vitreoretinal procedures are having longer duration, more invasive, using various intraocular tamponades, and with longer postoperative recovery time all of which might affect the frequency of postoperative ptosis. To the best of the authors' knowledge, there is no prior study on the frequency of postoperative ptosis and its related factors after the pars plana vitrectomy procedure (PPV).…”

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confidence: 99%

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Postoperative Blepharoptosis After Pars Plana Vitrectomy Procedure

Abdolalizadeh

Kashkouli

Falavarjani

et al. 2020

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To describe the frequency of blepharoptosis and factors affecting it after the pars plana vitrectomy (PPV) procedure. Methods: In a prospective study, patients were recruited consecutively from October 2016 to June 2018. Upper eyelid margin reflex distance 1 and 2 (MRD1 and 2), upper eyelid crease height, and levator function were measured before, 1 and at least 6 months after surgery by the same investigator. Clinical and Clinically significant ptosis were defined as ≥0.5 and ≥2 mm drop of MRD1. Result: There were 60 eyes from 57 patients. The majority of surgeries were performed by the fellows (63.3%, 38/60) and under general anesthesia (95.0%, 57/60). Clinical and clinically significant ptosis following PPV were 47.2% (25/53) and 11.3% (6/53) at the last follow up (at least 6 months), respectively. MRD2 (p = 0.389) and eyelid crease height (p = 0.057) did not significantly change. Surgeons’ level, time of the procedure and other variables were not significantly impacting the frequencies. Conclusion: Persistent clinically significant ptosis was observed in 11% of patients undergoing PPV. No variable was significantly associated with persistent postoperative ptosis after PPV.

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

Cited by 11 publications

References 12 publications

A prospective, randomised study of the effect of fixation sutures during phacotrabeculectomy on intraocular pressure and incidence of ptosis

A prospective, randomised study of the effect of fixation sutures during phacotrabeculectomy on intraocular pressure and incidence of ptosis

Changes in lower lid position after standard phacoemulsification cataract surgery

Postoperative Blepharoptosis After Pars Plana Vitrectomy Procedure

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