Abstract

P 305

Vision impairment immediately after blepharoplasy or ptosis surgery

Annette Pütz, Michael Bach, Hans Mittelviefhaus
Universitäts-Augenklinik Freiburg

Objective
After blepharoplasty or ptosis surgery there is an increased risk for exposure keratitis. In order to evaluate the impairment of patients by the postoperative prophylactic ointment treatment, we examined their postoperative visual acuity.
Methods
Fourteen consecutive patients who underwent blepharoplasty or ptosis surgery where examined postoperatively between Dec 2008 and March 2009. All patients were protected by dexpanthenol and gentamycin ointment only and had no eye patches or Frost sutures. Two hours postoperatively visual acuity was measured with a Visual Acuity Chart in 1 m distance (group I, n=7) or with the Freiburg Visual Acuity Test (FrACT) (group II, n=7).
Results
The preoperative visual acuity of the better eye was 0.13 / 0.03 logMAR (group I / group II). The postoperative corrected binocular visual acuity was 1.06±0.7 / 0.64±0.36 logMAR (mean±SD; group I / group II) which is equivalent to a decimal visual acuity of 0.09 / 0.23. This corresponds to a considerable impairment of vision in 9 of 14 patients (ICD-10-GM 2009: H54.2). At the first postoperative day 10 of 14 patients had a lagophthalmus and 7 patients had a significant superficial punctate keratopathy as a sign of exposure keratitis.
Conclusions
If eye patches or Frost sutures are omitted after blepharoplasty or ptosis surgery the alternative prophylactic ointment treatment will impair postoperative visual acuity to an extent that the patients are exposed to an increased risk (for example risk of falling) and will demand a higher degree of care.

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