J Korean Ophthalmol Soc > Volume 60(12); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(12):1275-1283.
DOI: https://doi.org/10.3341/jkos.2019.60.12.1275    Published online December 15, 2019.
Clinical Outcomes and Refractive Error Characteristics in Patients with Congenital Blepharoptosis after Ptosis Repair Surgery.
Ki Young Son, Yoon Duck Kim, Kyung In Woo, Kyung Ah Park
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. lethe22@hanmail.net
선천눈꺼풀처짐환자에서 눈꺼풀처짐교정술의 임상결과 비교 및 굴절이상 특성
손기영 · 김윤덕 · 우경인 · 박경아
성균관대학교 의과대학 삼성서울병원 안과학교실
Correspondence:  Kyung-Ah Park, MD
Email: lethe22@hanmail.net
Received: 2 August 2019   • Revised: 30 September 2019   • Accepted: 6 December 2019
Abstract
PURPOSE
We investigated changes in postoperative refractive error after surgery to treat congenital ptosis and the clinical outcomes by surgical method. METHODS: The study was retrospective and interventional. We enrolled 73 patients in whom 86 eyes exhibited visual axis-obscuring congenital ptosis. All patients were under 8 years of age, with refractive errors or amblyopia, and underwent maximal levator resection or frontalis sling surgery with fascia lata preservation from January 2008 to January 2018; the minimum follow-up time was 6 months. Visual and surgical outcomes were assessed by reviewing clinical photographs taken before and 1 year after surgery. Refractive error changes were measured at these times. RESULTS: Maximal levator resection was performed on 42 of 86 eyes (48.8%) and frontalis sling surgery with preservation of the fascia lata on 44 eyes, 95.2% and 75.0% of patients, respectively, exhibited good or fair surgical outcomes. The preoperative mean astigmatisms of the ptotic and control eyes of those with unilateral disease did not differ significantly: −0.71 ± 0.85 D for ptotic eyes and −0.66 ± 0.97 D for control eyes. The mean astigmatism increased from −0.71 ± 0.85 D preoperatively to −1.27 ± 1.2 D postoperatively (p < 0.001). The postoperative MRD1 value correlated with the increase in postoperative astigmatism (p = 0.022, r = −0.261). CONCLUSIONS: Maximal levator resection tended to afford better surgical outcomes than frontalis sling surgery with preservation of the fascia lata in patients with congenital ptosis. Patients in whom the postoperative eyelid position was good tended to exhibit higher refractive errors. Careful examination and treatment are recommended to ensure good visual outcomes.
Key Words: Astigmatism;Blepharoptosis;Congenital;Frontalis sling;Maximal levator resection


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