Axial Globe Length in Congenital Ptosis

To compare axial globe length between affected and unaffected sides in patients with unilateral congenital ptosis.

This prospective observational study included 37 patients (age range: 7 months to 58 years). The axial globe length, margin reflex distance-1 (MRD-1), and refractive power were measured. The axial globe length difference was calculated by subtracting the axial globe length on the unaffected side from that of the affected side. The relationships among axial globe length differences, MRD-1 on the affected sides, and patient ages were analyzed using multiple regression analysis.

No significant differences were found in the axial globe length between sides (P = .677). The axial globe length difference was 0.17 ± 0.30 mm (mean ± standard deviation), and two patients (5.4%), aged 32 to 57 years, showed axial globe length more than 0.67 mm longer (corresponding to a refractive power of 2 diopters) on the affected side compared to the unaffected side. The multiple regression model between axial globe length difference, patient age, and MRD-1 on the affected sides was less appropriate (YAGL = 0.003XAGE-0.048XMRD-1 +0.112; r = 0.338; adjusted r2 = 0.062; P = .127). The cylindrical power was greater on the affected side (P = .046), although the spherical power was not different between sides (P = .657).

No significant difference was identified in the axial globe length between sides, and only 5% of non-pediatric patients showed an axial globe length more than 0.67 mm longer on the affected side. Congenital ptosis may have little effect on axial globe length elongation, and the risk of axial myopia-induced anisometropic amblyopia may be low in patients with unilateral congenital ptosis.