Postsurgical ptosis associated with intraoperative eyelid dilatability

This prospective randomized controlled clinical study comprised 100 eyes of 50 patients. Phacoemulsification in both eyes was performed with topical or general anesthesia. Both lid specula – the Schott lid speculum for one and the Barraquer lid speculum for the other eye – were used on each patient. The palpebral fissure height, marginal reflex distance, levator function, and height of the lid crease were measured before and 1 month after surgery. Intraoperatively the lid aperture was measured with the lid speculum in place. The t test was used to compare means and the chi-square test was used for categorical variables.

Postsurgical ptosis of 2 mm or more was found in 18 eyes. There was no significant difference between the two specula used. The development of ptosis was associated with small intraoperative dilatability, reduced levator function, and younger age (p < 0.05).