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Incidence of upper eyelid ptosis in topical anesthesia after uncomplicated phacoemulsification

Poster Details

First Author: Z.Cakic CROATIA

Co Author(s): F. Kujundzic   B. Kuzmanovic Elabjer   M. Busic   M. Bjelos           

Abstract Details


To investigate the incidence of postoperative ptosis due to rigid eyelid speculum usage.


University J. J. Strossmayer Osijek, School of Medicine Osijek, University Hospital “Sveti Duh” Zagreb, University Eye Clinic


Palpebral aperture, distance to the upper (MRD1) and lower eyelid margin from the central corneal reflex were measured in patients scheduled for cataract surgery and followed up one week, one and three months after the surgery. Inclusion criterion was age ≥60 years. Exclusion criteria were previous surgery of both eyes and eyelids, congenital and involutional upper eyelid ptosis (UEP), thyroid eye disease, glaucoma and ocular injections. Uncomplicated phacoemulsification was performed in topical anesthesia by the same surgeon using rigid eyelid speculum. Persistent postoperative UEP was defined as decrease in MRD1 ≥1 mm compared to preoperative values that persisted ≥3 months.


Twenty patients met the criteria. There were 13 female and 7 males average age of 71.85 ± 5.85 years (range 63-82 years). Duration of the surgery was 11.5 ± 1.6 min (range 9-14 min). In 25% of cases (5/20 patients) postoperative ptosis was observed, that resolved within 4-12 weeks in 15% (3/20) patients. In 10% of cases (2/20) persistent postoperative ptosis of 1 mm after three months was documented.


Incidence of postoperative upper eyelid ptosis as a result of use of the rigid eyelid speculum was 10% being in correlation with other studies. Having ruled out other causes such as type of anesthesia and bridle sutures, rigid eyelid speculum plays major role in development of postoperative ptosis in our study population.

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