Clinical Evaluation of Ptosis after Peribulbar Anesthesia

We evaluated ten ptotic eyes of two hundred thirty eight eyes which had a peri bulbar anesthesia in aspects of sex, age and type of operation. Also we clinically evaluated the degree of ptosis, the function of levator muscle and postoperative interval to recovery of ptosis. The results were as follows: 1. Ptosis developed in 10 eyes (4.2%). Sex distribution was 8 females (80.0%) and 2 males (20.0%), and age distribution was from 44 to 83 years old. 2. At the postoperative 1 day, the most common degree of ptosis was severe form (60.0%), followed by mild form (30.0%) and moderate form (10.0%). In the function of levator muscle, 5 eyes (60.0%) were fair, followed by poor (30.0%) and good (20.0%). 3. The postopertive interval to recovery of ptosis was from 2 to 60 days, and then 5 eyes (50.0%) were Group II, followed by Group I (30.0%) and Group Ill (20.0%).

Clinical Examination on the Blepharoptosis and the Resection of the Levator Muscle

The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.