title: Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification.
abstract: OBJECTIVE
  To compare the incidence of upper eyelid blepharoptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification surgeries and the relationship of bleb morphology to the incidence of ptosis.
  
  
  METHODS
  Retrospective observation study.
  
  
  METHODS
  We included 46 patients after combined phacotrabeculectomy and 44 patients with phacoemulsification in the former group, and all eyes underwent a standardized two-site surgery with intra-operative mitomycin C.
  
  
  METHODS
  Postoperative ptosis was defined as a reduction of upper marginal reflex distance 2 mm in the operated eye compared to the fellow eye. Trabeculectomy bleb measurements were carried out using anterior segment optical coherence tomography (Visante™, Carl Zeiss Meditec, Dublin, CA, USA) which included bleb height and total area of the bleb.
  
  
  RESULTS
  There were 8 eyes (17.4%) and 5 eyes (11.4%) with postoperative ptosis in the phacotrabeculectomy and phacoemulsification groups, respectively (P = 0.342). In multivariate regression analysis, reduced total bleb area was significantly associated with upper eyelid ptosis after adjusting for age, gender, and type of anesthesia. The trend seemed to show that increased bleb height was also associated with ptosis, but this did not reach statistical significance.
  
  
  CONCLUSIONS
  Incidence of persistent ptosis after phacoemulsification combined with trabeculectomy and mitomycin C is similar compared to stand alone phacoemulsification surgery in a multiethnic Asian population. Bleb morphology may play an important role in postoperative ptosis development and should be considered in the evaluation of upper eyelid blepharoptosis.
authors: Victor
authors: V
authors: Koh
authors: Janina
authors: J
authors: Tatsios
authors: Paul T K
authors: PT
authors: Chew
authors: Department of Ophthalmology, National University Health System, Singapore.
authors: Shantha
authors: S
authors: Amrith
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D001763:Blepharoptosis / Q000175:diagnosis / Q000453:epidemiology*; D002386:Cataract / Q000150:complications; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin