Purpose: To clarify changes in tear volume and blinks before and after ptosis surgery in patients with glaucoma who used Prostanoid FP-Receptor Agonist eyedrops (PG eyedrops).
Subjects and methods: A total of 19 eyes from 10 patients (age 76.5±5.1 years, mean±SD) with glaucoma who had been using PG eyedrops for more than 1 year and who underwent ptosis surgery (levator advancement surgery) between March, 2013 and March, 2019 and could be followed up to 3 months postoperatively were included in the evaluation (PG group). The control group consisted of 159 eyes from 104 patients (mean age 68.8±10.6 years) who were not using PG eyedrops (non-PG group) during the same period. We examined tear volume (radius of curvature of tear meniscus R), spontaneous blinks, levator function, and the margin reflex distance-1 (MRD-1), before, 1.5 months after, and 3 months after ptosis surgery.
Results: Tear volume R (mm) was significantly lower in the PG group than in the non-PG group, with 0.23±0.02 and 0.30±0.01 before surgery and 0.18±0.01 and 0.25±0.01 mm at 3 months after surgery (p< 0.05 and p< 0.001, respectively). Distance of upper eyelid movement at eyelid closure was significantly shorter in the PG group than in the non-PG group at 3 months postoperatively, with 6.16±0.25 and 6.90±0.15 mm, respectively. As for preoperative and postoperative changes, MRD-1 increased significantly to+3.5 mm in the PG group at 1.5 months postoperatively, but there was no significant change in blink distance. Blink distance increased significantly to 1.0 mm with open eyelids and 0.5 mm with closed eyelids in the PG group at 3 months postoperatively; however, such increases were shorter than those in the non-PG group.
Conclusions: Tear volume in the PG group was small before surgery, and it was further decreased after Levator advancement surgery. Distance of upper eyelid movement at eyelid closure after surgery was shorter in the PG group, causing relative lid closure failure.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 127: 484-490,2023.