• Dr. Joynul Abedin

The incidences of ptosis occur in Bangladesh. Ptosis is an abnormally low position of the upper lid. However the present study has conducted to find out the influence of bridal suture and to identify the demographic factors and intraoperative surgical time in occurrence of postoperative ptosis. The study was conducted at selected different Hospitals at Chottogram District in Bangladesh. This was a randomized comparative prospective study. Total 260 patients were included and operated with small incision cataract surgery (SICS) using routine peribulbar block anesthesia by lidocaine 2% + bupivacaine(0.75%), use of wire speculum using superior conjunctival flap with superior incision. Post-operative patching of operated eye was done. Patients were randomly divided in to two groups. In group A SICS with superior rectus suture and in group B SICS without superior rectus suture with use of self-retaining wire speculum to separate the lids were used. Preoperative measurement for ptosis include MRD1, levator function test, preoperative photograph to compare it postoperatively on follow upand also recorded intra operative surgical time. Our criteria for postoperative ptosis are no ptosis or > 2mm or more drooping of upper lid as ptosis on measuring margin reflex distance (MRD1). MRD1 is a distance between upper lid margin and central corneal light reflex when patient in primary gaze position. Levator function is measured by (burke’s method) lid excursion caused by LPS muscle, normal function if 15mm or more excursion, good mm or more, fair 5-7 mm and poor if 4mm or less and preoperative photograph is taken by camera when patient in primary gaze position. All the preoperative measurements and photographs were compared with postoperative measurements at 1 month, 3 month and 6 month on follow up. Statistical analysis was done using Microsoft Excel. Data were collected from primary and secondary sources. Primary data were collected from the respondents of the study area. Secondary data were collected from books, research reports, journals, annual reports, Website of Ministry of Health and family planning internet etc. The tool was prepared by keeping the objectives of the study as the framework that reflect the study variables. A pre-designed semi-structured questionnaire was developed use as data collection instrument. Prior to the interview, the purposes of data collection were explained to the respondents and verbal consent was obtained. Data were collected by face-to-face interview by the investigator. From the study it was found that chances of occurrence of postoperative ptosis is slightly on higher side in patients operated with superior rectus suture than in whom it is not used , role of demographic factors provedno any significance, but longer operative time leads to more chances of occurrence of ptosis. In spite of above factors other factors also responsible for the postoperative ptosis and majority of ptosis gradually resolve its own over a period of one year. Postoperative ptosis is one of the major lid malposition after anterior segment surgeries like cataract, so surgeons can decrease the risk of ptosis following cataract surgery by avoiding bridle suture, using small, suture less temporal incisions and reducing operative time to complete surgery if possible.

Ptosis, Incidence, Cataract, Superior Rectus Bridle Suture, Surgery, Extraction

"POST Cataract Extraction Ptosis Following Superior Rectus Bridle Suture", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.10, Issue 8, page no.f71-f79, August-2023, Available :http://www.jetir.org/papers/JETIR2308511.pdf

"POST Cataract Extraction Ptosis Following Superior Rectus Bridle Suture", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.10, Issue 8, page no. ppf71-f79, August-2023, Available at : http://www.jetir.org/papers/JETIR2308511.pdf