Relationship between the phenylephrine test and eyelid droop after aponeurotic repair with the use of an epinephrine-containing local anaesthetic

Abstract

PurposeTo analyse the relationship between the results of the phenylephrine test and postoperative eyelid droop in transcutaneous aponeurotic repair using epinephrine-containing local anaesthetic for aponeurotic blepharoptosis.Patients and methodsWe retrospectively reviewed the medical records of 66 eyelids from 40 patients who underwent transcutaneous aponeurotic repair. A positive phenylephrine test result was defined as an increase in margin reflex distance-1 (MRD-1) ≥0.5 mm after application of phenylephrine eye drops. The patients were divided into a positive phenylephrine response group (Group A, 16 patients) and a negative phenylephrine response group (Group B, 24 patients). The MRD-1 was calculated by subtracting the 3-month postoperative value from the intraoperative value. Patient age, sex, pre-and intraoperative MRD-1s, levator function, and phenylephrine response were investigated as factors potentially influencing the MRD-1. The relationship between these factors and MRD-1 was analysed using single and multiple regression analysis.ResultsThe MRD-1 in Group A (0.68±0.52 mm) was significantly greater than that in Group B (0.17±0.56 mm; P=0.004). A moderate correlation was found between phenylephrine response and MRD-1 in the total patient group (Y MRD-1 =0.441 X phenylephrine +0.358; r=0.462; r 2 =0.213; P=0.002).ConclusionsAlthough the MRD-1 in Group B was quite small, the MRD-1 in Group A was considerable, and there was a moderate positive correlation between phenylephrine response and the MRD-1 overall. This indicates that the degree of postoperative eyelid droop can be estimated by the phenylephrine test results in transcutaneous aponeurotic repair.