The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis

Purpose: The primary objective of this study was to investigate the possible role and assess the potential relationship of speculum use during phacoemulsification surgery in the occurrence of blepharoptosis. Methods: Our study is a prospective observational design to analyze patients who underwent p...

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Main Authors: Savithiri Palanivel, Rajagopalan Jayagayathri, Dayakar Yadalla
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-02-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/IJO.IJO_1476_24
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author Savithiri Palanivel
Rajagopalan Jayagayathri
Dayakar Yadalla
author_facet Savithiri Palanivel
Rajagopalan Jayagayathri
Dayakar Yadalla
author_sort Savithiri Palanivel
collection DOAJ
description Purpose: The primary objective of this study was to investigate the possible role and assess the potential relationship of speculum use during phacoemulsification surgery in the occurrence of blepharoptosis. Methods: Our study is a prospective observational design to analyze patients who underwent phacoemulsification surgery under topical anesthesia between October 2017 and May 2018 at a tertiary eye hospital in South India. All patients had their Margin Reflex Distance 1 (MRD1), levator palpebrae superioris (LPS) function, and lid crease distance (LCD) measured before and after surgery on day one, one month, three months, and six months to evaluate the extent of ptosis at each time point that was recorded clinically and photographic documentation for accurate evaluation. Results: Out of the 221 patients who participated in the study, a total of 250 eyes were examined. On postoperative day one, 34 patients (15.8% with a rigid speculum and 11.4% with a non-rigid speculum) developed ptosis. At the one-month follow-up, ptosis persisted in four patients, with one patient having undergone surgery using a rigid speculum and the rest of three patients with a non-rigid speculum. However, further follow-ups at three and six months revealed a complete resolution of ptosis in all cases, indicating that the ptosis was transient and resolved spontaneously. Conclusion: Speculum use cannot be considered as the sole causative factor for postoperative ptosis, as a multitude of other modifiable factors, such as superior rectus bridle suturing, anesthetic approach, prolonged patching, and duration of surgery, may have an additive effect alongside speculum used in the development of postoperative ptosis.
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1998-3689
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spelling doaj-art-69ff58cde00245f99716185148618c1a2025-02-06T05:39:35ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-02-0173221021310.4103/IJO.IJO_1476_24The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysisSavithiri PalanivelRajagopalan JayagayathriDayakar YadallaPurpose: The primary objective of this study was to investigate the possible role and assess the potential relationship of speculum use during phacoemulsification surgery in the occurrence of blepharoptosis. Methods: Our study is a prospective observational design to analyze patients who underwent phacoemulsification surgery under topical anesthesia between October 2017 and May 2018 at a tertiary eye hospital in South India. All patients had their Margin Reflex Distance 1 (MRD1), levator palpebrae superioris (LPS) function, and lid crease distance (LCD) measured before and after surgery on day one, one month, three months, and six months to evaluate the extent of ptosis at each time point that was recorded clinically and photographic documentation for accurate evaluation. Results: Out of the 221 patients who participated in the study, a total of 250 eyes were examined. On postoperative day one, 34 patients (15.8% with a rigid speculum and 11.4% with a non-rigid speculum) developed ptosis. At the one-month follow-up, ptosis persisted in four patients, with one patient having undergone surgery using a rigid speculum and the rest of three patients with a non-rigid speculum. However, further follow-ups at three and six months revealed a complete resolution of ptosis in all cases, indicating that the ptosis was transient and resolved spontaneously. Conclusion: Speculum use cannot be considered as the sole causative factor for postoperative ptosis, as a multitude of other modifiable factors, such as superior rectus bridle suturing, anesthetic approach, prolonged patching, and duration of surgery, may have an additive effect alongside speculum used in the development of postoperative ptosis.https://journals.lww.com/10.4103/IJO.IJO_1476_24levator palpebrae superiorispost operative ptosisptosisspeculum related ptosissuperior rectus bridle suture,
spellingShingle Savithiri Palanivel
Rajagopalan Jayagayathri
Dayakar Yadalla
The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
Indian Journal of Ophthalmology
levator palpebrae superioris
post operative ptosis
ptosis
speculum related ptosis
superior rectus bridle suture,
title The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
title_full The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
title_fullStr The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
title_full_unstemmed The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
title_short The impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery: A prospective analysis
title_sort impact of speculum uses on the incidence of blepharoptosis in patients undergoing phacoemulsification surgery a prospective analysis
topic levator palpebrae superioris
post operative ptosis
ptosis
speculum related ptosis
superior rectus bridle suture,
url https://journals.lww.com/10.4103/IJO.IJO_1476_24
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