Abstract
Purpose :
To investigate incidence of Blepharoptosis after Trabeculectomy, Phaco-trabeculectomy and Ahmed
Glaucoma valve (AGV) and compare it with phacoemulsification
Methods :
In this prospective case control study, 102 glaucomatous eyes as a case group and 28 nonglaucomatous
eyes (with uneventful phaco surgey) as a control group were included. Glaucoma surgeries were
Trabeculectomy (41 eyes; 40%), Phaco-trabeculectomy (34 eyes; 33%) and AGV (27 eyes; 27%). MRD1 (The
distance between upper eyelid and central corneal reflex) was measured before surgery and 1, 3 and 6 months
after the surgery. Ptosis was defined as a MRD1 difference (ΔMRD1) more than 2mm at the end of month 6. P value <5% was
considered as significant.The correlation among ΔMRD and clinical factors such as age, gender , type of surgeries, type of anesthesia, duration of surgery ,laterality ,surgeons( attending ,fellowships and residents) were analyzed.
Results :
Mean age of the patients was 57.93±16.23 and 60.8% were male. Mean preoperative MRD1 was
2.97±0.96 and 3.15±1.11 in control and case group, respectively. Mean post-operative MRD1 at the end of month 6 was 2.78±1.18 in control group (Paired t-test, p=0.30), while it was 2.57±1.21 in glaucomatous patients (Paired t-test, p<0.0001). Overall, in 5.5% after phacoemulsification and 13.7% after glaucoma surgeries ptosis was observed postoperatively. Ptosis occurred in 13.5%, 17.2% and 20% of eyes following Trabeculectomy, Phacotrabeculectomy and AGV, respectively. However, there was no significant difference in the incidence of ptosis considering type of glaucoma surgery (Kruskal-Wallis; p=0.784).There was no statistically significant relationship between age, laterality, duration,surgeon, type of anesthesia and the rate of ptosis.Only Male gender significantly associated with post op ptosis (17% vs.2.5%)
Conclusions :
Ptosis occured in considerable number of patients after Trabeculectomy, Phaco trabeculectomy and
AGV. However, there was no noticeable difference between different types of glaucoma surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.