J Korean Ophthalmol Soc.  2013 Jul;54(7):1006-1012. 10.3341/jkos.2013.54.7.1006.

A Prospective Study of Blepharoptosis after Panretinal Photocoagulation Using Ophthalmoscopic Contact Lens

• Kim YJ
• Lim HW
• Kang MH
• Seong MC
• Cho HY

• KMID: 2217408
• DOI: http://doi.org/10.3341/jkos.2013.54.7.1006

Abstract

PURPOSE
To investigate the possibility of blepharoptosis as a complication after panretinal photocoagulation using ophthalmoscopic contact lens.
METHODS
We prospectively evaluated patients who were diagnosed with diabetic retinopathy and scheduled to be treated with panretinal photocoagulation. Margin reflex distance 1 (MRD1), levator function, palpebral fissure height and width, and tarsal plate height were measured at the day of photocoagulation and 3 months after treatment.
RESULTS
MRD1 was decreased in 8 eyes (25.8%), levator function was decreased in 5 eyes (16.1%), and palpebral fissure height was decreased in 6 eyes (19.4%). The decrement of MRD1 and palpebral fissure height after photocoagulation were significant (p = 0.008, p = 0.031, respectively). There was a significant negative correlation between MRD1 decrement and tarsal plate height (p = 0.045).
CONCLUSIONS
We identified blepharoptosis after panretinal photocoagulation using contact ophthalmoscopic lens, which was related with low tarsal plate height.

Keyword

Blepharoptosis; Diabetic retinopathy; Ophthalmoscopic contact lens; Panretinal photocoagulation; Ptosis

MeSH Terms

Blepharoptosis
Diabetic Retinopathy
Eye
Humans
Light Coagulation
Prospective Studies
Reflex

Figure

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  Figure 1. Distribution of the MRD1 before panretinal photocoagulation.

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  Figure 2. Distribution of the levator function before panretinal photocoagulation.

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  Figure 3. Distribution of the patients classified into 4 groups by Δ MRD1.

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  Figure 4. Significant negative correlationbetween Δ MRD1 and tarsal plate height using correlation analysis (R2=0.132).

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  Figure 5. Superquad 160® contact ophthalmoscopiclens (Volk Optical, Inc., USA). The diameters of the eye contact part of each ophthalmoscopic lens are about 16.5 mm, respectively, and the shaft of each contact ophthalmoscopic lens comes in contact with the upper eyelid at an angle of 40 degrees.

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  Figure 6. The illustration shows the relation between the eye-lid and contact ophthalmoscopic lens. When the contact oph-thalmoscopic lens is fitted to the eyes, the lower part of the up-per eyelid is bent against the patient’s eyes and the dehiscence or disinsertion at the insertion part of levatoraponeurosis could occur (arrow).

Reference

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