선천눈꺼풀처짐 교정술 후 발생한 난시변화

Changes in Astigmatism after Surgery for Congenital Ptosis

Purpose: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. Methods: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. Results: The mean astigmatism was 1.33±1.29D preoperatively and 1.48±1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56±0.55D and +0.68±0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57±0.67D which was similar to those who received levator resection (+0.56±0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. Conclusions: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.