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Ocular movement abnormalities and ptosis after glaucoma surgery: A retrospective decade long analysis
Carlo Catti1,2,3, Federica Tessitore1,2, Daniele Ferrari1,2
1IRCCS Ospedale Policlinico San Martino, University Eye Clinic of Genoa, Genoa, Italy.
Plos One
|October 30, 2025
Summary
Glaucoma surgery can lead to rare complications like ptosis and strabismus. Muscle isolation procedures showed a higher incidence of these conditions, including the combination of both.
Area of Science:
- Ophthalmology
- Surgical Complications
- Glaucoma Management
Background:
- Glaucoma surgery aims to reduce intraocular pressure but can cause ocular motility and eyelid complications.
- Ptosis (drooping eyelid) and strabismus (misaligned eyes) are potential adverse events following ophthalmic procedures.
Purpose of the Study:
- To determine the prevalence of ptosis and strabismus after glaucoma surgery.
- To identify specific glaucoma surgical techniques associated with a higher risk of these complications.
Main Methods:
- Retrospective analysis of 705 patient records from glaucoma surgeries performed between 2010 and 2020.
- Surgical procedures were categorized into 'Ab interno', 'Ab externo', and 'Muscle isolation' groups.
Main Results:
- Ptosis occurred in 3.7% of patients, with a higher incidence (5.7%) after muscle isolation surgery.
- Strabismus was observed in 1.7% of patients, significantly more frequent after extraocular muscle manipulation (7.5%).
- The combined occurrence of ptosis and strabismus was 1.0%, with a higher prevalence (1.9%) following muscle isolation procedures.
Conclusions:
- Ptosis, strabismus, and their combination are infrequent complications of glaucoma surgery.
- Glaucoma surgeries involving muscle isolation techniques are most strongly associated with these adverse outcomes.
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