[The effect of the method for forming the conjunctival flap in glaucoma fistulizing operations on the development of a stable acquired ptosis of the upper eyelid].

The relationship between the incidence rate and severity of acquired ptosis and the technique of the conjunctival flap formation in trabeculectomy were under study. A total of 117 patients were followed up. In 70 the flap was formed by the traditional method, with the foot to the limbus, and in 47 by the nontraditional technique, with the foot to the vault and radially. Stubborn (a follow-up of more than 6 mos postoperation) acquired ptosis of the upper eyelid was observed in 38.5% of patients; it was more often after the traditional technique of the conjunctival flap formation (48.6%) and rare and approximately to the same extent when nontraditional methods were used (23.4%). The incidence rate and severity of ptosis increase as the height of the incision on the conjunctiva (from the limbus), made by the traditional technique of the flap formation, grows. A more frequent development of ptosis after traditional formation of the conjunctival flap vs. the nontraditional techniques may be explained by injuries to the individual branches of the oculomotor nerve, participating in the innervation of the posterior peduncle of the levator muscle of the upper eyelid.