Ptosis After Cataract Surgery, A Case Report And Literature Review
Published 2025 - 43rd Congress of the ESCRS
Reference: PO286 | Type: Free paper | DOI: 10.82333/qmqc-8c19
Authors: Yuexi Chen* 1 , Zheng Wang 1 , Jiansu Chen 1
1Guangzhou Aier Eye hospital,Jinan University,Guangzhou,China
Purpose
To present a case with right eye ptosis soon after cataract surgery
Setting
Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Methods
A case report and literature review
Results
A 84-year-old female, suffered from right eye complete ptosis after right eye cataract surgery immediately. There was no eyelid edema and hematoma. Ocular examination revealed right eye complete ptosis, EOM all directions limitation and a smaller pupil (2.5mm) compared to the left eye (3.5mm). PCIOL was well in situ without any inflammation in the anterior segment. CN III/IV/VI palsy, horner pupil and complete ptosis indicated a cavernous sinus lesion or systemic problem.Brain MRI revealed an enhanced nodular lesion around the cavernous segment of the right internal carotid artery, which was an aneurysm . After discussing with neurologists, observation of the ICA aneurysm was suggested due to slow progression of the aneurysm.
Conclusions
Blepharoptosis is often an over-looked complication of routine cataract surgery. Although anesthesia myotoxicity and the use of lid speculum are the common cause of small incisional phacoemulsification, brain lesion may sometimes be the cause. Pre-operative test such as eyelid examination (Hering's test), extraocular muscle motility, pupil size of both eyes should be done routinely to avoid any hidden disease. Mild ptosis may sometimes be found by keratometry and topography. Careful examination should always be done by a cataract surgeon before performing this “high-expectation” surgery nowadays.