Spektrum der Augenheilkunde

, Volume 31, Issue 5, pp 179–182 | Cite as

Postsurgical ptosis associated with intraoperative eyelid dilatability

  • Ewald Lindner
  • Sabine Stohl-Mayr
  • Julia Rossbacher
  • Doris Putzgruber-Adamitsch
  • Stephanie SarnyEmail author
  • Yosuf El-Shabrawi
original article



In this study we determined the incidence of postsurgical ptosis following phacoemulsification using different lid specula.


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).


While the choice of lid speculum had no influence on the development of postsurgical ptosis, the amount of intraoperative vertical dilatability and younger age did have an effect.


Phacoemulsification Schott lid speculum Barraquer lid speculum Postsurgical ptosis 

Postoperative Ptose ist mit intraoperativer Liddehnbarkeit assoziiert



Die Inzidenz einer postoperativen Ptose nach Phakoemulsifikation mit unterschiedlichen Lidspekula wurde mit der vorliegenden Studie geprüft.


In der prospektiven, randomisierten, kontrollierten Studie wurden 100 Augen von 50 Patienten untersucht. Phakoemulsifikation an beiden Augen erfolgte in Lokal- oder Tropfanästhesie. Zwei Lidspekula, das Schott-Lidspekulum und das Barraquer-Lidspekulum für das andere Auge, wurden bei jedem Patienten angewendet. Präoperativ und ein Monat postoperativ wurden die vertikale Lidspaltenhöhe, Lidrand-Pupillenreflex-Abstand, Levatorfunktion und der Deckfaltenabstand in Primärposition gemessen. Intraoperativ erfolgte die Messung der Lidöffnung mit dem Lidspekulum in situ. Der T‑Test wurde für die Berechnung von Mittelwerten und der Chi-Quadrat-Test (χ2-Test) für kategorische Variablen angewendet.


Eine postoperative Ptose von 2 mm wurde bei 18 Augen festgestellt. Es zeigte sich kein signifikanter Unterschied zwischen den Lidspekula. Das Entstehen einer Ptose war assoziiert mit verminderter, intraoperativer Liddehnbarkeit, reduzierter Levatorfunktion und geringerem Alter (p < 0,05).


Das Ausmaß der intraoperativen Liddehnbarkeit und geringeres Alter stehen in signifikantem Zusammenhang mit der Entwicklung einer postoperativen Ptose. Die Wahl des Lidspekulums während der Phakoemulsifikation hat keinen Einfluss.


Phakoemulsifikation Schott-Lidspekulum Barraquer-Lidspekulum Postoperative Ptose 


Compliance with ethical guidelines

Conflict of interest

E. Lindner, S. Stohl-Mayr, J. Rossbacher, D. Putzgruber-Adamitsch, S. Sarny, and Y. El-Shabrawi declare that they have no competing interests.

Ethical standards.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Ewald Lindner
    • 1
    • 2
  • Sabine Stohl-Mayr
    • 1
  • Julia Rossbacher
    • 1
  • Doris Putzgruber-Adamitsch
    • 1
  • Stephanie Sarny
    • 1
    Email author
  • Yosuf El-Shabrawi
    • 1
    • 2
  1. 1.Department of OphthalmologyGeneral Hospital KlagenfurtKlagenfurtAustria
  2. 2.Department of OphthalmologyMedical University GrazGrazAustria

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