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Refractive status and ocular biometric parameters in children undergoing the levator muscle-conjoint fascial sheath
Ting Fu1,2, Shunguo Ma1,2, Huiyang Ai1,2
1Department of Ophthalmology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
Insights
Congenital blepharoptosis surgery may temporarily increase astigmatism and steep keratometry. Long-term refractive outcomes are generally stable, though severe cases may experience a myopic shift.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Surgical Innovation
Background:
- Congenital blepharoptosis can affect ocular development and visual function.
- Surgical correction aims to improve eyelid position and visual outcomes.
- Understanding the impact of surgical techniques on ocular biometrics is crucial.
Purpose of the Study:
- To evaluate the effect of levator muscle-conjoint Fascial Sheath Complex Suspension on ocular biometrics and refractive status in children with congenital blepharoptosis.
Main Methods:
- Retrospective review of 68 patients with congenital blepharoptosis undergoing ptosis surgery.
- Analysis of corneal topography and refractive characteristics preoperatively and at 1, 3, and 6 months postoperatively.
Main Results:
- Preoperative ptosis eyes showed flatter keratometry, thicker subfoveal choroidal thickness, and higher astigmatic magnitude compared to non-ptosis eyes.
- Postoperative unilateral ptosis exhibited increased steep keratometry and astigmatic magnitude at 1 month, with astigmatism persisting at 3 months.
- Severe ptosis correlated with the greatest postoperative change in astigmatic magnitude.
Conclusions:
- Ptosis repair surgery can lead to early postoperative increases in steep keratometry and astigmatism.
- Long-term refractive status appears stable post-surgery.
- Severe unilateral ptosis may result in a significant myopic shift at 6 months.
Purpose:
To evaluate the effect of the levator muscle-conjoint Fascial Sheath Complex Suspension on ocular biometric parameters and refractive status in children with congenital blepharoptosis.
Methods:
We reviewed the clinical records of 68 patients with congenital blepharoptosis who attended our hospital from 2021 to 2023 and underwent ptosis surgery with detailed examination. The changes of corneal topography and refractive characteristics before and 1 month, 3 months, 6 months after surgery were compared and analyzed.
Results:
Before surgery, ptosis eyes had statistically significant flatter flat keratometry (P = 0.015), thicker subfoveal choroidal thickness (P = 0.021), higher astigmatic magnitude(P = 0.006) than non-blepharoptosis eyes. The 1-month postoperative steep keratometry and the astigmatic magnitude were significantly higher than the preoperative values in unilateral ptosis (P = 0.032, P = 0.014), without affecting astigmatic power vectors and central corneal thickness (P > 0.05); The astigmatic magnitude at 3 months after surgery were higher than the preoperative values in unilateral ptosis (P = 0.042). In all patients, the postoperative change of astigmatic magnitude was greatest in severe ptosis.
Conclusions:
Ptosis repair surgery for congenital ptosis seems to cause increase of steep K value and astigmatism over early postoperative period but no refraction alteration over the long-term postoperative period. A significant myopic shift was observed at the 6-month postoperative follow-up in severe unilateral ptosis.
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