Ocular abnormalities associated with unilateral coronal synostosis

Forty-five patients with premature fusion of one coronal suture were treated between June 1985 and June 1991. Thirty-three patients were evaluated with pre- and postoperative photographs, computed tomographic scans, and serial radiographs and were assessed by the ophthalmological and plastic surgical services before and after surgery. The patients' mean age was 11.5 +/- 3.2 months at the time of surgery. Two patients (6%) were noted to have facial abnormalities preoperatively. Seventeen patients (52%) exhibited a disorder of extraocular muscle function preoperatively. After craniofacial repair, 21% of patients exhibited a distinct change from their preoperative ocular examination. A substantial majority of patients with premature fusion of the unilateral coronal suture (72%) will present with an abnormal examination postoperatively. In addition, a significant percentage of these patients will exhibit a change in ophthalmological status after craniofacial surgery; therefore, surgery on the extraocular musculature should, in general, be deferred until after bony repositioning.