Possible corneal aberrometric changes after upper eyelid ptosis surgery

Document Type : Original Article


1 Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Psychiatry and Community Health Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran


Background: Congenital upper eyelid ptosis is a common benign disorder in children that may cause visual and functional problems as well as cosmetic problems. Treatment of ptosis is indicated in cases of visual impairment or cases of cosmetic problems. Vision is disturbed not only when the pupil is covered by eyelid, but also by causing refractive errors. Ptosis can cause astigmatism through interference with the visual axis (stimulus deprivation) and lead to amblyopia.
Objectives: This study was performed aimed to investigate the changes in the shape and function of the cornea by topography, aberrometry and Orbscan in the eye with congenital ptosis before and after surgery of ptosis.
Methods: This descriptive analytical study was performed on 15 patients aged 5-30 years with unilateral congenital ptosis who met the inclusion criteria. Complete ophthalmological examinations were performed in all patients. Patients underwent ptosis correction surgery in the form of levator resection. The patients were referred to the paraclinical unit for corneal imaging before and one month after the surgery, and topography, orbscan and aberrometry were performed in the ptotic eyes before and after the operation (30 eyes)..
Results: The mean age of the patients was 21.8 ± 5.9 years. The minimum astigmatism changes in orbscan of ptotic eyes were 43.31±1.5 D before the surgery and 43.8±1.5 D after the surgery, which was significant (P=0.02). No significant changes were observed in other findings of the orbscan. Also, the mean changes of Vertical Coma in aberrometry of ptotic eyes were significant before and after the surgery (P=0.02). None of the topographical variables in ptotic eyes showed significant changes before and after the surgery. In patients with corneal astigmatism > 1 D, some aberrometric changes were statistically significant (HO w/o Z400 6mm, P=0.023).
Conclusion: Ptosis surgery corrects vertical coma in aberrometry and minimum keratometry (Sim'K Min) in orbscan, but it has no effect on other measured items. If there is a corneal astigmatism > 1 D, the aberrometric changes following surgery are more obvious.


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