Blepharoptosis after Ocular Surgery and Aponeurosis Repair

ABSTRACT

PURPOSE: We retrospectively investigated the etiological factors and evaluated the surgical results of aponeurosis repair for blepharoptosis after ocular surgery. METHODS: We investigated the types of ocular surgery, anesthesia, and other etiological factors related with postoperative blepharoptosis for 20 eyes of 20 patients and evaluated MRD1 (Margin Reflex Distance 1), IPF (Interpalpebral Fissure) and levator function preoperatively and after levator aponeurosis repair surgery. RESULTS: Types of previous ocular surgery were cataract surgery (15 eyes), penetrating keratoplasty (2 eyes), retinal surgery (2 eyes) and panretinal photocoagulation using gonioscopic lens (1 eyes). 18 eyes had received ocular surgery with rigid type eye speculum and 18 eyes with retrobulbar anesthesia. Mean levator function measured preoperatively was good (12 mm). We found dehiscence or detachment of levator aponeurosis in surgical field and performed aponeurosis repair or advancement with correction 2 mm more than MRD1 of normal contralateral eye. Mean IPF and MRD1 were improved 6 months after aponeurosis repair (from 4 mm, -0.5 mm to 7 mm, 2 mm respectively). CONCLUSIONS: This study indicates that blepharoptosis after ocular surgery can be induced by rigid type eye speculum, local anesthesia and various causes. Surgical findings of blepharoptosis after ocular surgery were dehiscence or detachment of levator aponeurosis and could be corrected by aponeurosis repair effectively.