Intraocular pressure changes after levator aponeurosis advancement for aponeurotic ptosis in eyes with and without a filtering bleb.

PURPOSE: To evaluate intraocular pressure (IOP) changes after levator aponeurosis advancement (LAA) for acquired aponeurotic ptosis and compare eyes with and without glaucoma-filtering blebs. METHODS: This retrospective study included consecutive patients undergoing LAA at the University of Tokyo Hospital between May 2016 and November 2017. IOP was measured via Goldmann applanation tonometry preoperatively and at 1 and 3 months postoperatively. Eyes were classified by the presence of filtering blebs. Patients with ocular abnormalities other than glaucoma were excluded. A linear mixed-effects model with a random intercept per patient assessed the effects of time, bleb status, and interaction. RESULTS: Sixteen (32%) of 50 eyes from 48 patients had filtering blebs. Baseline IOP did not differ significantly between groups. Adjusted IOP changes at 1 and 3 months were not significantly different between eyes with and without filtering blebs. Within-group analysis showed a significant IOP reduction at 3 months in non-bleb eyes (p = 0.020), with no significant change at 1 month (p = 0.051). Bleb eyes showed no significant change at 1 month (p = 0.170) or 3 months (p = 0.790). CONCLUSIONS: LAA for aponeurotic ptosis did not cause early postoperative IOP increases in eyes with filtering blebs. Postoperative IOP changes were similar between groups.