Abstract
Purpose :
The incidence of ptosis after trabeculectomy has been reported to be 12-19%. Ptosis surgeries in eyes with filtration bleb require careful consideration because overcorrection may result in bleb exposure which could increase the risk of blebtitis or endophthalmitis. But there are only few reports about safety of ptosis surgery after trabeculectomy. In this study, we compared postoperative course of aponeurotic ptosis surgery in eyes with bleb and those without bleb to assess efficacy and safety of ptosis surgery for eyes with filtration bleb.
Methods :
Subjects were 45 eyes of 37 patients who had undergone aponeurotic ptosis surgery. We divided eyes into two groups, Bleb group (group B); ptosis with filtration blebs after trabeculectomy, and Non-Bleb group (group N); ptosis after other intraocular surgery. We evaluated preoperative levator function (LF), intraocular pressure (IOP), margin reflex distance (MRD) and tear meniscus height (TMH) measured by Keratogragh 5M (OCULUS Inc.), fluorescein staining score (FS:0-9), and Schirmer test (ST) at before (Pre), 1 month (POM1) and 3 months (POM3) after ptosis surgery. We also checked postoperative complications and patients’ satisfaction.
Results :
Eighteen eyes of 17 patients (mean age 72.4 ± 10.6 years) were included in group B and 27 eyes of 20 patients (mean age 78.0 ± 6.2 years) were included in group N. Preoperative LF in group B and N were 11.1 ± 2.4 and 10.2 ± 2.3 mm. At pre / POM1 / POM3 in groupB and N, IOP were 11.9 ± 4.0 / 11.2 ± 3.3 / 12.1 ± 3.5 and 12.9 ± 3.6 / 13.1 ± 3.0 / 11.6 ± 2.3 mmHg, MRD were 0.4 ± 0.6 / 3.2 ± 1.3 / 2.6 ± 1.3 and 0.3 ± 0.6 / 2.7 ± 1.2 / 2.5 ± 1.2 mm, respectively. In group B, TMH were 0.4 ± 0.2 / 0.3 ± 0.2 / 0.4 ± 0.2 mm, FS were 1.1 ± 0.8 / 1.4 ± 0.9 / 1.6 ± 1.6 and ST were 10.9 ± 7.8 / 6.8 ± 6.4 / 8.5 ± 7.1 mm, respectively. In each measurement item, there was no statistically significant between group B and N. In group B, there was no case of leakage or infection of blebs after ptosis surgery. One eye showed recurrence of ptosis at POM1. In group N, there were two eyes which improved MRD, although the patients requested residual skin resection. In all other 43 eyes, subjective symptoms were improved.
Conclusions :
Safety and efficacy of aponeurotic ptosis surgery for bleb eyes are equivalent to that of ptosis surgery after other intraocular surgeries.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.