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Kim, Moon, and Kim: Comparison of Ptosis Occurrence after Cataract Surgery Depending on Anesthetic Methods
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1226-1230.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1226

Comparison of Ptosis Occurrence after Cataract Surgery Depending on Anesthetic Methods

Young Kook Kim, MD, Ji Young Moon, MD, Sung Jin Kim, MD

Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

Address reprint requests to Sung Jin Kim, MD. Department of Ophthalmology, Eulji General Hospital, #14 Hangeulbiseok-gil, Nowon-gu, Seoul 139-872, Korea. Tel: 82-2-970-8271, Fax: 82-2-970-8272, ksj4107@eulji.ac.kr

Received 19 May 2011       Accepted 12 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

The authors of the present study conducted a comparative analysis of procaine hydrochloride topical anesthesia and Nadbath-Rehman-Ellis akinesia to observe orbicularis oculi stress against the eyelid speculum and occurrence of postoperative ptosis.

Methods

In 40 eyes of 20 patients, 1 eye underwent a cataract operation by topical anesthesia and the other eye underwent Nadbath-Rehman-Ellis akinesiaDepending on the anesthetic method, the 2 groups were evaluated to determine the difference in marginal reflex distance and levator function after the surgery.

Results

There were no significant differences between the 2 groups in the mean preoperative MRD1 which was 2.5 ± 0.4 mm and levator function which was 9.0 ± 1.1 mm. After 1 week and 4 weeks, the mean MRD1 on eyes with topical anesthesia was 2.0 ± 0.3 mm and 2.3 ± 0.3 mm, respectively, and the mean MRD1 on eyes with Nadbath-Rehman-Ellis akinesia was 2.3 ± 0.2 mm and 2.4 ± 0.4 mm, respectively, which was significantly lower (p = 0.046, 0.042). The levator functions showed no significant differences. The reduction of MRD1 over 2 mm was shown only in the group with topical anesthesia which was significantly higher in comparison to the group with Nadbath-Rehman-Ellis akinesia which had none.

Conclusions

In cataract surgery, Nadbath-Rehman-Ellis akinesia can reduce damage to the levator aponeurosis decreasing the occurrence of postoperative ptosis.

Keywords: Nadbath-Rehman-Ellis akinesia, Procaine hydrochloride topical anesthesia, Ptosis

Figures and Tables

Table 1
Ptosis evaluation after cataract surgery
jkos-53-1226-i001

Values are presented as mean ± SD.

MRD1 = Marginal Reflex Dsitance 1.

*Topical anesthesia(+), Nadbath akinesia(-); †Topical anestheia(+), Nadbath akinesia(+); ‡Significant difference from Pre-op by t-test (p = 0.041, 0.045) §Significant difference from Group A by t-test (p = 0.046, 0.042).

Table 2
Incidence of post-op. ptosis
jkos-53-1226-i002

*Topical anesthesia(+), Nadbath akinesia(-); †Topical anestheia(+), Nadbath akinesia(+); ‡Significant difference from Group A by Chi-square test (p = 0.047).

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