Surgical blepharoptosis--the bridle suture factor?
OBJECTIVE
To evaluate the role of the superior rectus bridle suture in the development of post cataract blepharoptosis.


METHODS
We compared the incidence of postoperative ptosis in two groups of patients undergoing cataract extraction. In the first group (32 patients), a temporal corneal approach was employed with no superior rectus bridle suture. In the second group (38 patients), a superior approach with a bridle suture was used. Both groups of patients underwent phacoemulsification with the use of peribulbar anaesthesia, a pressure lowering device and a speculum. We recorded the lid position at least 12 weeks following surgery and determined the degree of postoperative ptosis. Two-sided Fischer's Exact Test was used to test for significant difference between the two groups (using a statistical software package Instat Version 3.0 for Windows).


RESULTS
Taking 2 mm of ptosis as a significant change, 11.5% of those undergoing temporal section sustained postoperative ptosis whilst it occurred in 12.9% of those who underwent a superior approach.


CONCLUSIONS
The presence or absence of the superior rectus bridle suture and the site of the ocular wound do not significantly contribute to the incidence of postoperative ptosis. We would suggest that the causative factors are peribulbar anaesthesia, a pressure lowering device and the use of the speculum.
Kent County Ophthalmic & Aural Hospital, Maidstone, Kent, UK. jigs37@hotmail.com
J I
JI
Patel
M
M
Blount
C
C
Jones
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects; D001763:Blepharoptosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques / Q000009:adverse effects*; D014143:Traction / Q000009:adverse effects