Eyelid malpositions after cataract surgery

Purpose. To estimate the incidence and the factors that may play a role in the etiology of eyelid malpositions after cataract extraction. Methods. We followed up 124 patients for six months after cataract extracti on. Palpebral aperture, levator function, height of the upper lid crease, l ower eyelid laxity and position of the punctums were recorded preoperativel y and postoperatively. Post-cataract ptosis was defined as a 2 mm or greate r drop in the lid margin after correcting for any change in the fellow eye. Results. None of the patients developed ectropion or entropion, but five (4 %) developed punctal ectropion after surgery. The incidence of post-catarac t ptosis was 7.3% at six months. Age, sex, preoperative measurements of lev ator function, lid crease and dermatochalasis were not predictive for the d evelopment of ptosis at six months. However, there was a significant differ ence in the preoperative palpebral fissure width between the patients with ptosis and those without (p<0.05). There was a positive correlation between the mean volume of local anesthetic and the degree of ptosis on the first postoperative day (p<0.05, r: 0.1873). The presence and amount of ptosis on the first postoperative day was the best predictor of postcataract ptosis at six months (p<0.001). Conclusions. Several factors are involved in the development of post-catara ct ptosis. Temporary ptosis may be related to the myotoxicity of the local anesthetic. The presence of ptosis on the first postoperative day is the be st predictor for the development of ptosis at six months.