Purpose

To determine the degree and rate of ptosis in patients undergoing glaucoma and cataract surgery.

Methods

Patients undergoing cataract extraction (CE), trabeculectomy, or glaucoma drainage device (GDD) placement, or a combination, were consecutively enrolled by a sole surgeon. Eyelid measurements, including margin reflex distance 1 (MRD1) and levator function, were obtained preoperatively and at 1 and 3 months postoperatively. Primary outcome measures were the change in MRD1 pre- vs postoperatively; percentage of patients with ptosis (defined as MRD1 < 2 mm pre- vs postoperatively). Secondary measures were the absolute change in MRD1 between groups, decrease in MRD1 of ≥ 2 mm, and change in levator function.

Results

In total, 104 eyes of 73 patients underwent CE, trabeculectomy, or GDD placement and completed at least 1-month follow-up; 93 eyes of 65 patients completed 3-month follow-up. MRD1 decreased significantly in trabeculectomy and GDD groups at 1 and 3 months postoperatively, while it did not change in the CE group. The GDD group had a significant increase in percentage of patients with ptosis at 3 months postoperatively.

Conclusion

Patients who underwent glaucoma surgery, especially those who underwent GDD placement, were more likely to have postoperative ptosis than patients undergoing CE alone. High ptosis rates in patients undergoing glaucoma surgery may warrant preoperative counseling and post-operative referral to oculoplastic surgeons.

中文翻译：

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青光眼引流装置放置和其他眼前节手术后上睑下垂率增加：前瞻性分析。

目的

确定接受青光眼和白内障手术的患者上睑下垂的程度和发生率。

方法

接受白内障摘除术 (CE)、小梁切除术或青光眼引流装置 (GDD) 植入术或联合手术的患者由唯一的外科医生连续入组。眼睑测量值，包括边缘反射距离 1 (MRD1) 和提肌功能，在术前和术后 1 个月和 3 个月获得。主要结局指标是术前与术后 MRD1 的变化；上睑下垂患者的百分比（定义为术前与术后 MRD1 < 2 mm）。次要指标是组间 MRD1 的绝对变化、MRD1 减少≥ 2 mm 以及提肌功能的变化。

结果

总共73例患者的104只眼接受了CE、小梁切除术或GDD置入术，并完成了至少1个月的随访；65 名患者的 93 只眼完成了 3 个月的随访。术后 1 个月和 3 个月，小梁切除术和 GDD 组的 MRD1 显着降低，而 CE 组没有变化。GDD组术后3个月上睑下垂患者的百分比显着增加。

结论

接受青光眼手术的患者，尤其是接受 GDD 植入的患者，比单独接受 CE 的患者更容易出现术后上睑下垂。接受青光眼手术的患者的高上睑下垂率可能需要术前咨询和术后转诊给眼整形外科医生。