Upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C.
OBJECTIVE
To describe 3 cases of upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C and to highlight possible causes.


METHODS
A report of 3 patients, identified over an 8-year interval period, who had development of upper eyelid retraction a few months after undergoing trabeculectomy with mitomycin C in the ipsilateral eye.


RESULTS
Testing for Graves disease, including second-generation thyrotropin receptor antibodies (TRAb), was negative in all cases. A complete physical examination was performed by an internist: Orbital and intracranial neuroimaging studies were ordered when necessary, and all were negative. One patient underwent surgical repair of the eyelid retraction and had a satisfactory result.


CONCLUSIONS
Upper eyelid retraction after filtering surgery is a rarely reported entity. Müller muscle overaction, independent of Graves disease, is a likely cause and has been pointed out as a possible factor in one previous report. Müller muscle fibrosis, euthyroid Graves disease, and mechanical hindrance to an elevated bleb are other possible factors.
Awwad
Shady T
ST
Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. sawwad@eyeweb.org
Ma'luf
Riad N
RN
Noureddin
Baha'
B
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D003228:Conjunctiva / Q000187:drug effects; D005141:Eyelid Diseases / Q000209:etiology* / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D014130:Trabeculectomy / Q000009:adverse effects*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin