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Published on: September 20, 2024
Refractive changes following congenital ptosis surgery
Mohamad Watad1, Moamen Masalha1, Tamara Wygnanski-Jaffe2
1Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Insights
Congenital ptosis surgery can cause significant refractive changes in pediatric patients. Regular eye exams are crucial after surgery to monitor vision and guide treatment.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Refractive Error
Background:
- Congenital ptosis, a drooping eyelid present from birth, can affect vision and appearance.
- Surgically induced refractive change (SIRC) is a potential complication following ptosis correction.
- Understanding SIRC is vital for optimizing surgical outcomes in pediatric patients.
Purpose of the Study:
- To evaluate the occurrence and magnitude of surgically induced refractive changes (SIRC) after congenital ptosis surgery.
- To compare pre-operative and post-operative refractive parameters in pediatric patients undergoing ptosis correction.
- To assess the impact of congenital ptosis surgery on visual acuity and refractive status.
Main Methods:
- Retrospective review of medical records from 24 pediatric patients (age < 18) who underwent congenital ptosis surgery.
- Collected pre-operative and at least 3-month post-operative cycloplegic refraction data.
- Analyzed surgically induced refractive change (SIRC) and marginal reflex distance-1 (MRD-1).
Main Results:
- Congenital ptosis surgery led to significant refractive changes in the operated eyes of pediatric patients.
- Most patients experienced over 0.5D change in sphere, cylinder, and spherical equivalent post-surgery.
- Marginal reflex distance-1 (MRD-1) improved significantly from 1.04 mm to 2.36 mm post-operatively.
Conclusions:
- Congenital ptosis surgery is associated with surgically induced refractive changes in a majority of pediatric patients.
- Close monitoring with frequent cycloplegic refraction examinations is recommended post-surgery.
- Determining optimal timing for ptosis surgery and subsequent visual management is essential.
Purpose:
To evaluate surgically induced refractive changes (SIRC) after congenital ptosis surgery. Methods: Data from 24 pediatric patients (age less than 18years old) who underwent congenital ptosis correction surgery between 2012 and 2020 and underwent cycloplegic refraction prior to and at least 3months postoperatively was retrieved from medical records at Sheba Medical Center. The Surgically induced refractive change (SIRC), marginal reflex distance-1 (MRD-1) after surgery were compared to before surgery.
Results:
Twenty-four patients were included in this study (16 boys and 8 girls) in a median age at the time of surgery of 1.82years. Eighteen patients underwent frontalis sling (FS), 3 levator resection (LR), 2 Müller's muscle-conjunctival resection (MMCR) and 1 LA (l levator advancement). MRD1 improved from 1.04 mm pre-operatively to 2.36 mm post-operatively (p < .001, paired samples t test). A significant surgically induced refractive change was found post-operatively in the operated eye and most patients were found to have more than 0.5D change in all examined parameters (sphere, cylinder, and spherical equivalent).
Conclusions:
Congenital ptosis surgery induces refractive change in most of the patients. Close follow up including frequent examination of cycloplegic refraction is required in order to determine the preferable timing of ptosis surgery and treatment following surgery.
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