After cataract surgery, most people focus on how clearly they see. Occasionally, though, someone notices that one upper eyelid sits a little lower than before. This is called ptosis. A systematic review published in November 2026 gathered the evidence on how often ptosis follows modern cataract surgery and what might raise the risk.
What the researchers did
A team in Italy followed standard PRISMA methods and searched PubMed and the Cochrane trials register through February 2026. They found 8 studies including 863 eyes that had modern phacoemulsification cataract surgery with a lens implant.
What they found
- Five studies reported how often ptosis occurred. Rates ranged from 0% to 10.7%, but four of the five, covering 96% of the eyes in those studies, reported rates of 4.1% or less.
- The other three studies compared eyelid height before and after surgery and found no statistically significant change.
- Weaker eyelid-lifting muscle function and a higher eyelid position before surgery were identified as possible risk factors.
- Length of surgery and the type of eyelid holder were not consistently linked to ptosis.
- Studies that used only numbing drops, rather than injections around the eye, reported either no ptosis or no significant change.
What this means
The authors concluded that ptosis after modern cataract surgery is uncommon but not negligible, and that it should be routinely discussed before surgery. If a lid stays lower after surgery, an oculoplastic surgeon can evaluate it.
Questions to ask before cataract surgery
- Do my eyelids already sit low, or is the lifting muscle weak?
- What kind of anesthesia will be used?
- Who should I contact if my lid looks lower weeks after surgery?
It also helps to take a straight-ahead photo of your face before surgery, so you have a baseline to compare. For more plain-language reading on eye health, see ineed2020.com.
Source: Blepharoptosis after modern phacoemulsification cataract surgery: incidence, risk factors, and underlying mechanisms (Journal of Cataract & Refractive Surgery (PubMed), 11/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.