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Related Experiment Video

Updated: Dec 12, 2025

Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
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Changes in Lower Lid Position after Standard Phacoemulsification Cataract Surgery.

María García Zamora1,2, Victoria E Marqués Fernández1, María Calabuig Goena1

  • 1Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain.

Journal of Current Ophthalmology
|August 11, 2020
PubMed
Summary

Phacoemulsification surgery causes mild lower eyelid laxity, indicated by changes in the lacrimal punctum distance and margin reflex distance 2 (MRD2). While the distraction test tends to recover, these lid position changes persist 180 days post-surgery.

Keywords:
Distraction testLacrimal lower punctumLid laxityLower lid positionMargin reflex distancePhacoemulsification

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Area of Science:

  • Ophthalmology
  • Surgical Outcomes
  • Oculoplastics

Background:

  • Phacoemulsification is a common cataract surgery technique.
  • Assessing post-surgical lower eyelid position is crucial for patient outcomes.
  • Pre-existing lower eyelid laxity is common in elderly cataract patients.

Purpose of the Study:

  • To objectively evaluate lower eyelid position changes following phacoemulsification surgery.
  • To quantify alterations in eyelid laxity parameters after cataract extraction.

Main Methods:

  • Prospective study of 112 cataract patients undergoing phacoemulsification.
  • Objective measurements included distraction test, lower lacrimal punctum distance, and margin reflex distance 2 (MRD2).
  • Standardized digital photographs were taken preoperatively and at multiple postoperative intervals (1-180 days).

Main Results:

  • A statistically significant increase in mean MRD2 was observed post-surgery (P=0.02).
  • The mean distraction test showed a slight decrease, tending towards preoperative levels by 180 days (P=0.02).
  • Lower lacrimal punctum distance showed a non-significant trend towards increase (P=0.06).

Conclusions:

  • Phacoemulsification leads to mild lower eyelid laxity, evidenced by increased MRD2 and lacrimal punctum distance.
  • These changes in eyelid position persist up to 180 days post-surgery.
  • Even short procedures like phacoemulsification can contribute to increased lower eyelid flaccidity in elderly patients.