Impact of prostaglandin-related antiglaucoma medication use on levator aponeurosis advancement outcomes

PURPOSE: To evaluate postoperative eyelid height at 3 months after levator aponeurosis advancement with or without concomitant skin excision in eyes with and without prostaglandin-related antiglaucoma medication use. METHODS: This retrospective single-center study included patients who underwent levator aponeurosis advancement with or without concomitant skin excision for acquired ptosis. The primary outcome was postoperative margin reflex distance 1 (MRD-1) at 3 months. A linear mixed-effects model was used to evaluate factors associated with postoperative MRD-1, including prostaglandin-related antiglaucoma medication use and previous glaucoma surgery. RESULTS: Seventy-two eyes from 46 patients were analyzed; 35 received prostaglandin-related antiglaucoma medication, and 37 did not. Mean preoperative MRD-1 was significantly lower in the medication group (0.30 ± 0.82 mm vs 0.85 ± 0.83 mm, P = 0.006). Postoperative MRD-1 at three months did not differ significantly between groups. MRD-1 improvement was greater in the medication-use group (P = 0.024). Prostaglandin-related medication use was not significantly associated with postoperative MRD-1 after adjustment for preoperative MRD-1, age, sex, concomitant skin excision, and previous glaucoma surgery. CONCLUSION: Eyes administered prostaglandin-related antiglaucoma medication had a lower preoperative MRD-1 than eyes without such medication use. However, postoperative MRD-1 at 3 months was comparable between the groups. Prostaglandin-related medication use was not significantly associated with postoperative MRD-1 after adjustment for previous glaucoma surgery and other covariates.