Exploring ptosis development after pars plana vitrectomy

The surgeons’ experience level and length of the procedure were among the factors that did not influence ptosis development.

Persistent ptosis can develop following pars plana vitrectomy, but the pathogenesis of the complication remains undetermined, reported Mohsen Bahmani Kashkouli, MD, corresponding author from the Eye and Skull Base Research Centers, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Dr. Kashkouli and colleagues undertook a prospective study¹ for which they recruited consecutive patients from October 2016 to June 2018.

The investigators measured the upper eyelid margin reflex distances 1 and 2 (MRD1 and 2), upper eyelid crease height, and levator function preoperatively and at 1 month and a minimum of 6 months postoperatively.

The same investigator performed all of the measurements. In this study, clinical and clinically relevant ptosis were defined, respectively, as 0.5 mm and greater and a 2-mm and greater decrease in the MRD1.

Ptosis findings in study patients
A total of 60 eyes of 57 patients were included in the study.

Fellows performed most of the procedures (63.3%, 38/60), and the vast majority of the patients were under general anesthesia during the surgeries (95.0%, 57/60).

At least 6 months after pars plana vitrectomy at the final examination visit, clinical ptosis developed in 47.2% (25/53), and clinically relevant ptosis developed in 11.3% (6/53).

The MRD2 (p = 0.389) and eyelid crease height (p = 0.057) did not change significantly, the investigators reported.

The factors that did not influence the development of ptosis included the surgeons’ experience level and length of the procedure.

The authors concluded, “Persistent clinically significant ptosis was observed in 11% of patients who underwent pars plana vitrectomy. No variable was associated significantly with persistent postoperative ptosis after PPV.”

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Mohsen Bahmani Kashkouli, MD
E: mkashkouli2@gmail.com
Kashkouli did not indicate a proprietary interest in the subject matter.

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Reference

1. Abdolalizadeh P, Kashkouli MB, Falavarjani KG, et al. Postoperative blepharoptosis after pars plana vitrectomy procedure. Ophthalmic Plast Reconstr Surg. 2021;37:432-4; doi: 10.1097/IOP.0000000000001890