Etiological Factors of the Ptosis After Cataract Surgery

To investigate the change in upper eye lid position after cataract operation with retrobulbar anesthesia and bridle suture, we studied 60 eyes of 60 patients randomized into 3 groups, group I received retrobulbar anesthesia and bridle suture, group II received retrobulbar anesthesia and group III received topical anesthesia.The measurement of interpalpebral fissure, levator function were taken at pre-op, post-op 1 week, post-op 4 weeks.The post operative mean palpebral fissure height and mean levator function decreased compared with those of the preoperative state but there were improvement of their ptosis with times.The incidence of ptosis at post operative 4 weeks was highest in group I with both retrobulbar anesthesia and bridle suture and lowest in group III with topical anesthesia (p=0.035).The result of this study indicate that ptosis after cataract surgery can be induced by various our operative techniques including retrobulbar anesthesia and bridle suture.We found there'll be many other causes of ptosis from the result of variant ptosis in group III with topical anesthesia.

A Prospective Study of Ptosis following Cataract Surgery

A prospective study was investigated to evaluate the effect of local anesthesla, surgical technique of cataract and superior rectus muscle injury on postoperative ptosis. Preoperative and postoperative measurements of palpebral fissure, margi reflex distance(MRD), margin limbal distance(MLD), levator function and photograph were taken. Two hundreds patients were randomized into four groups to study these effect. Group A received a Van Lint eyelid block and a superior rectus bridle suture. Group B received a Van Lint block and an episcleral retraction suture. Group C received an O'Brien eyeli block and a superior rectus bridle suture. Group D received an O'Brien block and an episcleral retraction suture. Postoperative measurements of palpebral fissure, margin reflex distance(MRD), margin limbal distance(MLD), levator functi and photograph were taken at first day and eight weeks postoperatively and ptosis patients of a drop in the lid margin of a 2mm or more were follow up at six months postoperatively. Ptosis patients of a drop in the lid margin of 2mm or more were found in 20% of group A, 18% of group B, 14% of group C, 4% of group D, and 14% of all cases. Postoperative ptosis was statistically reduced in group D at eight weeks postoperatively(compared with group A and D P=0.0091, group B and D P=0.0042, group C and D P=0.0268). It appears that trauma to the superior retus muscle complex is the most critical factor in postoperative ptosis and we could minimize this effect in group D.