Incidence and Risk Factors for the Ptosis after Trabeculectomy
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3341/jkos.2020.61.6.645
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Hyung Jun PARK
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sung Hyun KIM
			        		
			        		;
		        		
		        		
		        		
			        		Mi Jung CHI
			        		
			        		;
		        		
		        		
		        		
			        		Jong Yeon LEE
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Ophthalmology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Journal of the Korean Ophthalmological Society
	            		
	            		 2020;61(6):645-649
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:Korean
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Purpose:To investigate the incidence and risk factors for the ptosis after trabeculectomy. 
				        	
				        
				        	Methods:We retrospectively analyzed the medical records of 94 patients who underwent trabeculectomy by a single surgeon. Patients with previous eyelid surgery and ophthalmic surgery, as well as those with systemic disease affecting the eyelid, were excluded from the study. Ptosis was defined as higher eyelid crease compared with contralateral eyelid or a ≥2 mm reduction of margin reflex distance-1 after the surgery. Age, sex, bleb location, conjunctival incision site, mitomycin C concentration, range of mitomycin C contact area, and soaking time were analyzed. 
				        	
				        
				        	Results:The incidence of ptosis was 19.1% (18/94) at 6 months after trabeculectomy. There were no statistically significant relationships between postoperative ptosis and the following factors: age, sex, surgical site, bleb site, and conjunctival incision site. The incidence of ptosis was significantly higher in the 0.04% mitomycin C group than in the 0.02% mitomycin C group (40.0% vs 11.6%, p = 0.002). The incidence of ptosis was significantly higher in eyes with a large contact area of mitomycin C to the posterior part of the eye, compared to eyes with a smaller contact area (44.4% vs 9.0%, p < 0.001). Logistic regression analysis showed that the range of mitomycin C contact area remained statistically significant. 
				        	
				        
				        	Conclusions:The large contact area of mitomycin C to the posterior part of the eye during trabeculectomy was found to be a risk factor for postoperative ptosis.