Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification.
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Date
2015-12
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Abstract
Objective: To compare the incidence of upper eyelid blepharoptosis after combined phacotrabeculectomy
with mitomycin C and phacoemulsification surgeries and the relationship of bleb morphology
to the incidence of ptosis. Design: Retrospective observation study. Participants: We included
46 patients after combined phacotrabeculectomy and 44 patients with phacoemulsification in
the former group, and all eyes underwent a standardized two‑site surgery with intra‑operative
mitomycin C. Materials and Methods: Postoperative ptosis was defined as a reduction of upper marginal
reflex distance 2 mm in the operated eye compared to the fellow eye. Trabeculectomy bleb measurements
were carried out using anterior segment optical coherence tomography (VisanteTM, Carl Zeiss Meditec,
Dublin, CA, USA) which included bleb height and total area of the bleb. Results: There were 8 eyes (17.4%)
and 5 eyes (11.4%) with postoperative ptosis in the phacotrabeculectomy and phacoemulsification groups,
respectively (P = 0.342). In multivariate regression analysis, reduced total bleb area was significantly
associated with upper eyelid ptosis after adjusting for age, gender, and type of anesthesia. The trend
seemed to show that increased bleb height was also associated with ptosis, but this did not reach
statistical significance. Conclusions: Incidence of persistent ptosis after phacoemulsification combined
with trabeculectomy and mitomycin C is similar compared to stand alone phacoemulsification surgery
in a multiethnic Asian population. Bleb morphology may play an important role in postoperative ptosis
development and should be considered in the evaluation of upper eyelid blepharoptosis.
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Keywords
Combined phacotrabeculectomy, phacoemulsification, postsurgery, ptosis
Citation
Koh Victor, Tatsios Janina, Chew Paul T K, Amrith Shantha. Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification. Indian Journal of Ophthalmology. 2015 Dec; 63(12): 895-898.