Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction（CLE）with phacoemulsification and multifocal intraocular lens（...Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction（CLE）with phacoemulsification and multifocal intraocular lens（IOL）implantation.展开更多
·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids....·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids.·METHODS:This was a retrospective analysis of 140 eyes of 87 patients(mean age 52.29±16.45 y;22 males,65 females)with upper eyelid ptosis.Totally 88.6%had aponeurotic and 11.4%had congenital ptosis.For the evaluation of the responses of the upper and lower eyelids to topical 2.5%phenylephrine,the scleral show height,the marginal reflex distance(MRD)between the inferior margin of the upper eyelid and pupillary light reflex(MRD1),and between the central portion of the lower eyelid and pupillary light reflex(MRD2)were measured at the 2^(nd),5^(th),and15^(th)minutes.The changes of MRD1 and MRD2 with time(ΔMRD1 andΔMRD2)were evaluated.·RESULTS:The mean MRD1,MRD2.and scleral show heights increased within 5 min after testing,remaining largely stable between the 5^(th)-15^(th)minutes.The percentage of eyes with a greater response in MRD1 increased with increased severity of ptosis(P<0.05).Eyes with aponeurotic ptosis were more responsive to phenylephrine testing than congenital ptosis.The mild ptosis group had lower scleral show measurements and higherΔMRD2 values.TheΔMRD1 andΔMRD2 values were poorly correlated in all measurement times.·CONCLUSION:Performing the phenylephrine test 5 min after instilling the reagent is adequate to assess the maximum response of the upper and lower eyelids.The upper and lower eyelid responses in phenylephrine testing are poorly correlated.However,theΔMRD2 is related with baseline scleral show degree that may be a postoperative predictive factor.Further studies are necessary to determine the relationship between the responses of the lower eyelids to phenylephrine testing.展开更多
文摘Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction（CLE）with phacoemulsification and multifocal intraocular lens（IOL）implantation.
文摘·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids.·METHODS:This was a retrospective analysis of 140 eyes of 87 patients(mean age 52.29±16.45 y;22 males,65 females)with upper eyelid ptosis.Totally 88.6%had aponeurotic and 11.4%had congenital ptosis.For the evaluation of the responses of the upper and lower eyelids to topical 2.5%phenylephrine,the scleral show height,the marginal reflex distance(MRD)between the inferior margin of the upper eyelid and pupillary light reflex(MRD1),and between the central portion of the lower eyelid and pupillary light reflex(MRD2)were measured at the 2^(nd),5^(th),and15^(th)minutes.The changes of MRD1 and MRD2 with time(ΔMRD1 andΔMRD2)were evaluated.·RESULTS:The mean MRD1,MRD2.and scleral show heights increased within 5 min after testing,remaining largely stable between the 5^(th)-15^(th)minutes.The percentage of eyes with a greater response in MRD1 increased with increased severity of ptosis(P<0.05).Eyes with aponeurotic ptosis were more responsive to phenylephrine testing than congenital ptosis.The mild ptosis group had lower scleral show measurements and higherΔMRD2 values.TheΔMRD1 andΔMRD2 values were poorly correlated in all measurement times.·CONCLUSION:Performing the phenylephrine test 5 min after instilling the reagent is adequate to assess the maximum response of the upper and lower eyelids.The upper and lower eyelid responses in phenylephrine testing are poorly correlated.However,theΔMRD2 is related with baseline scleral show degree that may be a postoperative predictive factor.Further studies are necessary to determine the relationship between the responses of the lower eyelids to phenylephrine testing.
