Postoperative Blepharoptosis After Modern Phacoemulsification Procedure

Kashkouli, Mohsen Bahmani; Abdolalizadeh, Parya; Es’haghi, Acieh; Nilforushan, Naveed; Aghaei, Hossein; Karimi, Nasser

doi:10.1016/j.ajo.2019.12.023

Cited by 12 publications

(33 citation statements)

References 22 publications

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“…Blepharoptosis is known to be a complication after cataract surgery 28 . In modern clear corneal suture-less phacoemulsification cataract surgery, it has been reported that there is more than 3% of cases with postoperative persistent clinically significant blepharoptosis 29 . In our study, we excluded participants who had history of intraocular surgery, but those who underwent unilateral cataract surgery were included in the analysis; therefore, this study design could not distinguish between cataract in the right and left eye, and it is possible that the association between blepharoptosis and cataract was not analyzed in the same eye.…”

Section: Discussionmentioning

confidence: 99%

Association between age-related cataract and blepharoptosis in Korean adults: a population-based study

Jung

et al. 2022

Sci Rep

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Cataract and blepharoptosis are both commonly encountered ophthalmic problems in older adults. Since they share similar risk factors, it is plausible that there may be an association between the two conditions. We examined data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2012 to determine if there is an association between age-related cataract and blepharoptosis. Multivariable adjusted logistic regression analysis was conducted to examine the odds ratio (OR) and 95% confidence interval (CI) for association of each specific type of cataract with presence of blepharoptosis. Of the 10,387 eligible participants, 4782 (46.0%) had cataract and 1419 (15.8%) had blepharoptosis. There were more participants with blepharoptosis in the cataract group, compared with those in the no cataract group. After adjusting for potential confounders, participants with blepharoptosis had a higher risk of total cataract (OR: 1.557, 95% CI 1.201–2.019) and nuclear subtype cataract (OR: 1.305, 95% CI 1.050–1.620). Blepharoptosis was associated with significantly higher odds of cataract in obese participants when compared with non-obese participants (p for interaction = 0.0236). Our study revealed a positive association between age-related cataract and blepharoptosis; it suggests that thorough ophthalmic assessment is needed when assessing patients who are planning cataract or blepharoptosis surgery.

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Section: Discussionmentioning

confidence: 99%

Association between age-related cataract and blepharoptosis in Korean adults: a population-based study

Jung

et al. 2022

Sci Rep

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“…The risk of ptosis after any anterior segment surgery increases for many reasons, including older age, race, gender, operative time, type of anesthesia, eyelid edema, orbital inflammation, frequent use of topical steroid eye drops, anesthesia type (i.e., retrobulbar vs. topical), use of a lid speculum, use of a superior rectus bridle suture, and type of surgery. 7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]38 Recent studies have shown less surgery-related ptosis, which likely reflects the use of more modern surgical techniques. 9,10 Consistent with previous studies, 9,10 a total 7 eyelids of 7 patients underwent PK in our study, but none of the patients underwent endothelial keratoplasty (EK).…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Most of the previous studies have reported eyelid ptosis following anterior segment surgery, and especially after cataract and glaucoma surgery. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] However, a few reports have appeared regarding ptosis correction surgeries in patients after keratoplasty. 6,7 For example, Michel et al 6 reported the use of Müller muscle-conjunctival resection (MMCR) without tarsectomy to treat ptosis in patients with a prior history of corneal surgery; however, they did not investigate the use of a bandage contact lens (BCL) after MMCR to protect the corneal grafts.…”

Section: Introductionmentioning

confidence: 99%

Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

Mangan

Ocak

Vural

et al. 2021

Korean J Ophthalmol

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Purpose To examine the efficacy of ptosis correction with a Müller muscle-conjunctival resection with or without tarsectomy (MMCR±T), combined with bandage contact lens (BCL) use, in corneal graft patients. Methods Seven patients with corneal grafts who underwent MMCR±T for treatment of ptosis were evaluated retrospectively. A BCL was applied to the grafts at the end of the surgery. The collected data included preoperative and postoperative visual acuity, marginal reflex distance 1 (MRD-1), presence of Hering’s dependency by the phenylephrine test, symmetry outcomes, and complications after MMCR±T. Results The average duration between the penetrating keratoplasty and MMCR±T was 14 months, with a follow-up time of 10.4 months after MMCR±T. Hering’s dependency was observed in four (57.2%) patients before MMCR±T, and MRD-1 was increased in all patients based on preoperative phenylephrine tests. The mean preoperative MRD-1 was −0.14 ± 0.55 mm, and the mean postoperative MRD-1 was 2.35 ± 0.89 mm ( p < 0.0001). Symmetry outcomes of perfect (<0.5 mm), good (0.5–1 mm), and fair (≥1 mm) were noted after MMCR±T in three, three, and one patients, respectively. During the follow-up, no obvious corneal epitheliopathy, keratitis, or corneal graft rejection/failure were noted in any cases. BCL use was well tolerated by all patients. Conclusions Most patients achieved good surgical outcomes with the application of the BCL to protect the graft and with the use of the phenylephrine test and Hering’s dependency to predict the final eyelid position and symmetry. MMCR±T combined with BCL may therefore represent an alternative approach for correction of ptosis in patients with corneal graft.

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“…Other more serious complications may include vitreous detachment [76], IOL dislocation [79], transient and persistent postoperative ptosis [80] or retinal detachment. The latter does not cause pain.…”

Section: Risk Factors In Cataract Surgerymentioning

confidence: 99%

Phacoemulsification: Proposals for Improvement in Its Application

2021

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A cataract is defined as opacity of the crystalline lens. It is currently one of the most prevalent ocular pathologies and is generally associated with aging. The most common treatment for cataracts is surgery. Cataract surgery is a quick and painless process, is very effective, and has few risks. The operation consists of removing the opacified lens and replacing it with an intraocular lens. The most common intraocular lens removal procedure that is currently used is phacoemulsification. The energy applied in this process is generated by ultrasonic waves, which are mechanical waves with a frequency higher than 20 kHz. A great deal of research on the different ways to perform the stages of this surgical procedure and the analysis of the possible side effects of the operation has been published, but there is little information on the technical characteristics, the intensities applied, and the use of ultrasound-emitting (U/S) equipment for cataract removal. More studies on the method and depth of absorption of ultrasonic waves in our visual system when performing the phacoemulsification procedure are needed. It would be advisable for health authorities and medical professionals to develop guidelines for the handling and use of ultrasonic wave-emitting equipment, such as those that exist for ultrasound and physiotherapy. This could help us to reduce undesirable effects after the operation.

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Postoperative Blepharoptosis After Modern Phacoemulsification Procedure

Cited by 12 publications

References 22 publications

Association between age-related cataract and blepharoptosis in Korean adults: a population-based study

Association between age-related cataract and blepharoptosis in Korean adults: a population-based study

Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

Phacoemulsification: Proposals for Improvement in Its Application

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