Comparison of Incidence of Belpharoptosis Following Phacoemulsification, Trabeculectomy, Phaco-Trabeculectomy and Ahmed Glaucoma Valve

Purpose: To investigate incidence of Blepharoptosis after Trabeculectomy, Phaco-trabeculectomy and Ahmed Glaucoma valve (AGV). Methods: In this prospective case control study, 102 glaucomatous eyes as a case group and 18 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. P value <5% was considered as significant. Results: Mean age of the patients was 57.93±16.23 and 70.8% 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 (Pairedt-test, p<0.0001). One eye (5.55%) after phacoemulsification and 14 eyes (13.7%) after glaucoma surgery acquired ptosis postoperatively. Ptosis occurred in 12%, 15% and 15% 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). Conclusion: 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.