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EH Black, L Basse, GJ Gladstone, BG Brazzo, FA Nesi, S Myint; Predicting Lagophthalmos in Ptosis Surgery . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1471.
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Purpose: To determine the frequency of post-operative lagophthalmos, and to determine whether intra-operative measures are predictive of post-operative amounts of lagophthalmos. Methods: A prospective study of 92 eyes of patients with aponeurotic ptosis was performed, of which 84 were primary surgeries and 8 were repeat surgeries. Data collected included levator function, the amount of levator advancement, the pre-operative MRD1, the intra-operative amount of lagophthalmos measured immediately after levator advancement and the amount of lagophthalmos seen at the completion of surgery. The ability of these factors to predict post-operative lagophthalmos at one week and one month was evaluated by means of statistical analysis. Results: In primary surgeries lagophthalmos was present post-operatively in 33% of eyes at one week and 14% at one month, while in repeat surgeries it was present in 62% and 50% respectively. The amount of lagophthalmos measured immediately after levator muscle advancement was a statistically significant (p<0.05) predictor of lagophthalmos seen post-operatively at one week, but not at one month. The amount present at the completion of surgery had borderline significance (p=0.0522) at one week only. Both the pre-operative MRD1 and levator function were statistically significant predictors of post-operative lagophthalmos at one month. Conclusion: Blepharoptosis repair, a common surgery performed by the oculoplastic surgeon has many possible complications, with lagophthalmos being the most troublesome. This complication may lead to corneal staining, irritation, tearing and a decrease in visual acuity. Pre-operative measures are statistically significant predictors of post-operative lagophthalmos, but intra-operative measures are not. We discuss the clinical significance of these factors.
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