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Ptosis can develop after sub-Tenon triamcinolone acetonide injection but can be resolved

Can J Ophthalmol. 2009;44(6):668-672.

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While 5% of eyes that received sub-Tenon injection of triamcinolone acetonide developed secondary ptosis, reconstructive surgery was successful, and satisfactory results were achieved after injection in all cases, a study found.

"A sub-Tenon [triamcinolone acetonide] injection can occasionally cause ptosis by inducing a disinsertion of the levator aponeurosis. However, surgical reconstruction can lead to successful resolution of the ptosis," the authors said.

The retrospective cross-sectional study examined 163 eyes, for a total of 147 cases that had 286 sub-Tenon injections of 10-mg or 20-mg triamcinolone acetonide. The study determined incidence of secondary ptosis after injection.

Secondary ptosis developed in eight eyes (5%) in the study; six eyes were treated with reconstructive surgery. Two eyes required additional sub-Tenon triamcinolone acetonide injections and did not experience worsening ptosis.

According to the study, improvement of the margin reflex distance was –1.3 mm to 2.3 mm (P = .027) after injections..