This article is more than 5 years old. Information may no longer be current.
Bell's phenomenon protects tear film, ocular surface after surgery
J Pediatr Ophthalmol Strabismus. 2008:45(6):350-355.
Click Here to Manage Email Alerts
Careful postoperative monitoring is necessary in patients with poor Bell's phenomenon in whom frontalis suspension surgery has induced lagophthalmos.
The study of three groups of pediatric patients — those with poor Bell's phenomenon (group 1; 23 eyes), those with intact Bell's phenomenon (group 2; 33 eyes) and an age-matched control group (group 3; 30 eyes) — showed that Bell's phenomenon prevents tear film instability and ocular surface damage in eyes with lagophthalmos induced by frontalis suspension surgery.
Ptosis correction of more than 5.5 mm or lagophthalmos of more than 5 mm could increase the risk of exposure keratopathy in patients with poor Bell's phenomenon. In group 1, the degree of lagophthalmos had a strong negative correlation with tear film breakup time at 1, 3 and 6 months postoperatively and a strong positive correlation with a higher mean fluorescein staining score at 6 months postoperatively.
"A poorly functioning Bell's phenomenon mechanism induces a dry eye state related to low breakup time with increased risk of ocular surface desiccation," the study authors said.