Postcataract extraction ptosis: Effect of the bridle suture

Abstract

Postcataract extraction ptosis is a common complication of cataract surgery. While many factors have been implicated in its etiology, trauma to the superior rectus/levator complex is considered the most important factor. We prospectively evaluated the effect of two superior rectus bridling techniques on the degree and severity of ptosis present three months after cataract surgery. All other potential variables were controlled for. Bridling the tendon of the superior rectus muscle using the direct, subconjunctival (open) approach results in significantly less severe ptosis than the standard technique of indirect transconjunctival (closed) bridling.

Blepharoptosis following ocular surgery

“…This is likely because of strong opposing forces between the levator complex and bridled superior rectus causing levator dehiscence. However, using an open subconjunctival approach for superior rectus bridling results in substantially decreased rates of postoperative ptosis (from 19 to 4%) when compared with a closed, transconjunctival approach [15]. There is disagreement regarding whether the development of a superior rectus hematoma during placement of the bridle suture leads to increased postoperative ptosis [8,9].…”

Eyelid Malposition After Cataract and Refractive Surgery

“…5 Loeffler et al 30 further supported the bridle suture theory by showing that modification of the classic bridle suture technique to avoid grasping the superior rectus tendon resulted in a significant reduction in the incidence and severity of postoperative ptosis (19% vs. 4%). 30 In contrast to these studies, Patel et al 16 retrospectively examined the rate of ptosis after superior scleral tunnel phacoemulsification with bridle suture versus temporal clear corneal incision with no bridle suture and found comparable rates. They speculated that peribulbar anesthesia, the pressure lowering device and the eyelid speculum were more likely causative factors.…”

Occurrence of Postoperative ptosis after cataract surgery in tertiary care hospital of south Gujarat area

“…This happens due to grasping of superior rectus bridle suture during passage of bridle suture and traction of superior rectus /levator complex by the bridle suture, which can cause levator aponeurotic dehiscence [5,7]. So,the purpose ofour prospective study isto find out various etiological factors causing postoperative ptosis especially role of superior rectus bridle suture, demographic factors and duration of surgeryin patients operated for cataract surgery in our institute.…”