Visual acuity improvement and reduced intraocular pressure after pars plana vitrectomy in post-cataract surgery endophthalmitis patients at Sanglah Hospital

Abstract

Introduction: Ptosis is a drooping or inferodisplacement of the upper eyelid. The most common type of congenital ptosis results from a poorly developed levator muscle. Marked ptosis that obstruct vision must be corrected in infancy to prevent amblyopia. Correction of bilateral congenital ptosis with significant amblyopia was performed in this case. The choice of surgery technique is frontalis suspension. Method: A case report of 12 years old boy with decrease of visual acuity since four years ago with dropping of both upper eyelid present at birth. Detail opthalmology examination on both eyes show an amblyopia, margin reflex distance-1, levator function is less than 4 mm, and postural change (chin lift). Correction of bilateral ptosis with frontalis suspension was performed and refraction measurement had done after correction. Result: The frontalis suspension give a good result in cosmetic with margin reflex distance +5 and +4, sixth month after correction. However, amblyopia persist after correction of ptosis and patient use a spectacles corresponding with best refraction measurement. Discussion: Correction bilateral congenital ptosis with visual axis occluded must be done in infancy to prevent amblyopia. Correction bilateral congenital ptosis with frontalis suspension give a good result in margin reflex distance and cosmetic.