Possible corneal aberrometric changes after upper eyelid ptosis surgery

Document Type : Original Article

Authors

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

Abstract

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 cosmetic problems. Vision is hampered not just when the pupil is obscured by the eyelid but also when refractive errors occur. Ptosis can cause astigmatism through interference with the visual axis (stimulus deprivation) and lead to amblyopia.
Objectives: This study 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.
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 on 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 the 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 corneal astigmatism > 1D, the aberrometric changes following surgery are more obvious.

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References

  1. Marenco M, Macchi I, Macchi I, Galassi E, Massaro-Giordano M, Lambiase A. Clinical presentation and management of congenital ptosis. Clin 2017:453-63 doi:10.2147/OPTH.S111118 PMid:28280295 PMCid:PMC5338973
  2. Jubbal KT, Kania K, Braun TL, Katowitz WR, Marx DP. Pediatric blepharoptosis. Semin Plast Surg. 2017; 31(01): 058-064. doi:10.1055/s-0037-1598631 PMid:28255291 PMCid:PMC5330798
  3. Örge FH, Boente CS. The lacrimal system. Pediatr Clin. 2014; 61 (3):529-39.
  4. Kumar DA, Agarwal A, Prakash G, Boptm NV, Packiyalakshmi S, Agarwal A. Effect of unilateral congenital ptosis on ocular higher order aberrations in children. Med Hypothesis Discov Innov Ophthalmol. 2013;2(3):86.
  5. Hornblass A, Kass LG, Ziffer AJ. Amblyopia in congenital ptosis. Ophthalmic Surg Lasers Imaging Retina. 1995;26(4):334-7. doi:10.3928/1542-8877-19950701-14
  6. Stärk N, Zubcov AA, Kast E, Gutermuth D. Amblyopia, refractive errors and strabismus in congenital ptosis. Ophthalmologe. 1996; 93(4):345-50.
  7. Uğurbaş SH, Zilelioğlu G. Corneal topography in patients with congenital ptosis. Eye. 1999;13(4):550-4. doi:10.1038/eye.1999.136 PMid:10692929
  8. Smolek MK, Klyce SD, Sarver EJ. Inattention to nonsuperimposable midline symmetry causes wavefront analysis error. Arch Ophthalmol. 2002;120(4):439–47. doi:1001/archopht.120.4.439 PMid: 11934317
  9. Finsterer J. Ptosis: causes, presentation, and management. Aesthet Plast Surg. 2003;27(3):193-204. doi:10.1007/s00266-003-0127-5 PMid:12925861
  10. Sussenbach EC, Thomas DA, Patterson EG, Bogorad DD. Keratoconus unmasked by unilateral ptosis repair. Ophthalmic Plast Reconstr Surg. 2012;28(2):e32-3. doi:10.1097/IOP.0b013e31821637b3 PMid:21562440
  11. Kirwan C, O’Keefe M, Soeldner H. Higher-order aberrations in children. Am J Ophthalmol. 2006;141(1):67-70. doi:10.1016/j.ajo.2005.08.031 PMid:16386978
  12. Brown MS, Siegel IM, Lisman RD. Prospective analysis of changes in corneal topography after upper eyelid surgery. Ophthalmic Plast Reconstr Surg. 1999;15:378-83. doi:10.1097/00002341-199911000-00002 PMid:10588243
  13. Zinkernagel MS, Ebneter A, Ammann-Rauch D. Effect of upper eyelid surgery on corneal topography. Arch Ophthalmol. 2007;125 (12):1610-2. doi:10.1001/archopht.125.12.1610 PMid:18071108
  14. Owji N, Khalili MR, Bazrafkan H, Heydari M. Long-term outcome of refractive errors in patients with congenital blepharoptosis who have undergone ptosis surgery. Clin Exp Optom. 2022;105(7):715-20. doi:10.1080/08164622.2021.1973344 PMid:34538220
Journal of Preventive and Complementary Medicine
Volume 2, Issue 2
June 2023
Pages 69-74

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History

  • Receive Date: 17 March 2023
  • Revise Date: 07 April 2023
  • Accept Date: 21 April 2023

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