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D.N. Sommerville, D.P. Hainsworth, D. Liu; Incidence of Lid Ptosis Following Vitreo–Retinal Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1476.
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To determine the incidence of post–operative ptosis in patients undergoing vitreo–retinal surgery.
This prospective study included 83 patients who were scheduled for vitreo–retinal surgery. Exclusion criteria included previous eyelid and/or retinal surgery, lid trauma, or malignancy of the orbital and peri–orbital structures. Standardized and repeated measurements of palpebral fissure and photographs were taken pre–operatively and at one week and one month post–operatively. All retinal surgeries were performed by the same retinal surgeon using standardized techniques and all photographs were taken by a standardized technique and later evaluated by a masked observer. The photographic measurements were compared with the clinical measurements. Ptosis was defined as a difference of at least 2 mm between the pre– and post–operative measurements. Surgical technique, duration of the procedure, and other factors were analyzed.
Of the 83 participants, there were 52 males and 31 females, ages 21 to 86 years. Retinal surgery was performed on 44 right eyes and 39 left eyes. There were 61 vitrectomies, 14 scleral buckles, and 8 combined procedures. Ten of the 83 patients (12.0%) developed ptosis of the operated eye as defined by the above criteria. Of these 10 patients, 5/61 (8.2%) had vitrectomy alone, 3/14 (21.4%) underwent scleral buckle, and 2/8 (25.0%) had a combination of the two. Ptosis occurred in 3 right eye and 7 left eyes. The photographic measurements were in agreement with the clinical measurements in 100% of the cases.
There is a significant incidence of ptosis following vitreo–retinal surgery. Possible mechanisms of post–retinal surgical ptosis include levator aponeurosis dehiscence secondary to minor lid trauma or lid speculum, extensive dissection, and/or post–operative edema. It is important to inform all patients for whom vitreo–retinal procedures are planned, and to include in their surgical consent, that ptosis may occur as a complication.
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