J Korean Ophthalmol Soc > Volume 53(9); 2012 > Article
Journal of the Korean Ophthalmological Society 2012;53(9):1226-1230.
DOI: https://doi.org/10.3341/jkos.2012.53.9.1226    Published online September 15, 2012.
Comparison of Ptosis Occurrence after Cataract Surgery Depending on Anesthetic Methods.
Young Kook Kim, Ji Young Moon, Sung Jin Kim
Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea. ksj4107@eulji.ac.kr
마취법 차이에 따른 백내장 수술 후 눈꺼풀처짐의 발생 비교
Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
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.
Key Words: Nadbath-Rehman-Ellis akinesia;Procaine hydrochloride topical anesthesia;Ptosis

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