Ptosis and Cataract Surgery

Kaplan, Linda J.; Jaffe, Norman S.; Clayman, Henry M.

doi:10.1016/s0161-6420(85)34046-0

Cited by 73 publications

(15 citation statements)

References 5 publications

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“…Some of the proposed mechanism behind the cause of ptosis after surgery include lid edema from locally administered anesthetic, initial myotoxic effects, and the compression of the upper eyelid against the orbital bones from the eyelid speculum reducing blood flow to the levator muscle contributing to the edema. 1 , 2 , 10 However, another study showed the rates of ptosis after cataract surgery were common in both local and general anesthesia groups. 11 Another theory is that the use of a lid speculum, stiffness of the lid speculum, and smaller palpebral fissures may play a greater role.…”

Section: Introductionmentioning

confidence: 99%

Ptosis after glaucoma surgery

Park¹,

Eliassi-Rad²,

Desai³

2017

OPTH

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PurposeEvaluate factors contributing to ptosis after glaucoma surgery.MethodsThree-year retrospective chart review from January 1, 2012, to January 1, 2015, 157 eyes, 3 surgeons, at Boston Medical Center, to determine the incidence of ptosis and the effects of each variable contributing to ptosis at 3 months after surgery. Each variable was analyzed using the chi-square or independent samples t-test analysis to determine statistical significance of ptosis compared with above variables.ResultsThe t-test or chi-square analysis showed that gender, steroid duration, use of mitomycin C, duration of surgery, and prior surgeries were not statistically significant factors for ptosis. There was a statistically significant association between those <70 years of age and ptosis (P<0.05), non-combined surgery and ptosis (P<0.05), shunting surgery and ptosis (P<0.05).ConclusionPtotic changes occurred more often in those who have shunting (Ahmed and Baerveldt) surgeries compared with filtering (trabeculectomy and Express) surgeries.

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Section: Introductionmentioning

confidence: 99%

Ptosis after glaucoma surgery

Park¹,

Eliassi-Rad²,

Desai³

2017

OPTH

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“…Kaplan et al suggested that potential causative factors may include local anesthesia, either through a volume effect or myotoxicity; the superior rectus bridle suture; the use of a lid speculum; the size and location of the incision; and upper eyelid edema [1]. They concluded that trauma to the superior rectus muscle by placement of a bridle suture was the most influential factor in postoperative ptosis development.…”

Section: Discussionmentioning

confidence: 99%

“…Ptosis incidence following cataract surgery has been reduced with the use of a recently developed phacoemulsification technique involving a small incision, with reported rates of 4–21 % [1–8]. Ptosis is generally defined as a decrease in the marginal reflex distance 1 (MRD1) of 2 mm or more in the postoperative measurement compared to the preoperative measurement [9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…The precise etiology of ptosis remains elusive, but is considered to be multifactorial. The most critical factor in postoperative ptosis appeared trauma to the superior rectus/levator complex caused by local anesthesia, superior rectus bridle suture, and lid speculum [1–7]. Preoperative ptosis showed no effect on postoperative ptosis [1], but preoperative visible iris sign was shown as a clinical sign of severe involutional ptosis [10].…”

Section: Introductionmentioning

confidence: 99%

“…The most critical factor in postoperative ptosis appeared trauma to the superior rectus/levator complex caused by local anesthesia, superior rectus bridle suture, and lid speculum [1–7]. Preoperative ptosis showed no effect on postoperative ptosis [1], but preoperative visible iris sign was shown as a clinical sign of severe involutional ptosis [10]. Puvanachandra et al reported the incidence of postoperative ptosis has reduced by changing from ECCE (18 %) to phacoemulsification (0 %) [9].…”

Section: Introductionmentioning

confidence: 99%

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Influence of upper and temporal transconjunctival sclerocorneal incision on marginal reflex distance after cataract surgery

et al. 2016

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BackgroundPtosis incidence following cataract surgery is reduced with a recently developed phacoemulsification technique using a small incision. However, it remains uncertain whether an upper transconjunctival sclerocorneal incision can cause minor blepharoptosis. In the present prospective study, patients underwent cataract surgery with either an upper or temporal 2.4-mm transconjunctival sclerocorneal incision. We measured the marginal reflex distance 1 (MRD1) preoperatively and postoperatively, and compared these measurements between the two different incision types. Further we explored the risk factors of the postoperative MRD1 reduction.MethodsThe study population included patients who underwent cataract surgery on both eyes at Aichi Medical University between October 2013 and September 2015. In each patient, one eye was operated using an upper 2.4-mm transconjunctival sclerocorneal incision, and the other with a temporal incision. We prespecified that an MRD1 difference of ≥0.5 mm between the pre- and post-surgical measurements indicated postoperative ptosis, which was a strict criterion. MRD1 was measured using digital photography, and we calculated the difference between the preoperative and postoperative MRD1 values. This change in MRD1 was compared between the groups with different incision locations. The change in MRD1 was analyzed by using the multivariate regression model including incision position (temporal or upper), preoperative MRD1, and preoperative distance between medial and lateral canthi.ResultsWe assessed data from a total of 34 patients. The mean change in MRD1 from pre-operation to post-operation measurements was −0.26 ± 0.93 with the temporal incision and −0.24 ± 0.86 with the upper incision. The mean difference in the change in MRD1 between the different two incision types was −0.02, with a 95 % CI of −0.24 to 0.20, establishing equivalence between these incision types. The multivariate regression analysis showed that the preoperative MRD1 was significantly associated with the reduction of MRD1 after surgery (p = 0.034).ConclusionsCataract surgery using upper and temporal 2.4-mm transconjunctival sclerocorneal incisions are clinically equivalent with regards to change in MRD1, and neither incision type caused critical postoperative ptosis. The longer preoperative MRD1 was significantly associated with the reduction of MRD1 after surgery.Trial registrationCurrent Controlled Trials UMIN000022310. Retrospectively registered 14 May 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0286-1) contains supplementary material, which is available to authorized users.

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Prevention of Post-Cataract Extraction Ptosis

Bullock¹

1986

Archives of Ophthalmology

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Ptosis and Cataract Surgery

Cited by 73 publications

References 5 publications

Ptosis after glaucoma surgery

Ptosis after glaucoma surgery

Influence of upper and temporal transconjunctival sclerocorneal incision on marginal reflex distance after cataract surgery

Prevention of Post-Cataract Extraction Ptosis

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