Abstract
Purpose :
Blinking and lid anatomy have been reported to affect intraocular anatomy and intraocular pressure (IOP).(1,2,3) We hypothesized that a lax lower lid decreases lid-related IOP fluctuation and aqueous movement during blinking which may impact trabecular function. This study seeks to determine the effect of ectropion repair by tarsal strip on IOP.
Methods :
In this retrospective study, we enrolled patients who underwent a single tarsal strip procedure from 2010-2015 by a single surgeon with at least 2 pre- and 2 post-operative IOP measurements. Exclusion criteria included a history of glaucoma treatment, posterior segment surgery, complex lid surgery, and repeat lid surgery within 1 year. Pseudophakic patients were included, although IOP measurements within three months of cataract surgery were excluded. If the cataract surgery was after the tarsal strip procedure, all IOP data after the date of the cataract surgery were excluded. Pre-and postoperative IOP measurements were compared.
Results :
49 eyes from 28 patients were enrolled (12 men, 16 women; mean age 78.7 ± 9.2 years). Mean IOP before and after tarsal strip surgery was 15.1 ± 2.2 vs. 13.8 ± 2.1 mm Hg, respectively (P< 0.001, 95% CI: -1.89 to -0.81; Mixed-effects linear model). Average IOP reduction was 8.6% (range -36.2% to +15.3%).
Conclusions :
IOP was reduced following tarsal strip repair for lower lid ectropion, suggesting that lid laxity may have an adverse effect on aqueous outflow. Further investigation is warranted to assess the relationships between lid laxity, aqueous movement, blinking, and glaucoma risk. Maintenance of normal lid position and function may be important for IOP regulation.
1. IOP Reduction in Tarsal Strip Procedure
Kaplan C, Grover S, Chalam KV
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 151. ARVO Poster 2014
2. Direct-Recorded Intraocular Pressure Variations in a Human Subject
Coleman DJ, Trokel S
Arch Ophthalmol. 1969;82(5):637-640.
3. Tight orbit syndrome: a previously unrecognized cause of open-angle glaucoma.
Lee GA, Ritch R, Liang SY, Liebmann JM, Dubois P, Bastian-Jordan M, et al.
Acta Ophthalmol. 2010;88:120–4
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.