Faculty Collaboration Database

Surgical Timing for Congenital Ptosis Should Not Be Determined Solely by the Presence of Anisometropia. Ophthalmic Plast Reconstr Surg 2019;35(4):374-377

Date

02/23/2019

Pubmed ID

30789542

DOI

10.1097/IOP.0000000000001284

Scopus ID

2-s2.0-85069292061 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

PURPOSE: Timing of surgery in children with congenital ptosis is a critical component of care, and anisometropia is frequently cited as an indication for early intervention. The purpose of this study is to evaluate the change in refractive error following surgery for congenital ptosis to better inform decisions regarding the timing of surgery.

METHODS: A retrospective review of clinical records was performed on patients who underwent surgical correction of congenital ptosis in an academic oculoplastic surgery practice from 2002 to 2017. Patients with complete preoperative and postoperative refractive data were included in the study. Changes in refractive error following surgery were analyzed.

RESULTS: Among 184 pediatric patients who underwent ptosis surgery during the study period, 56 patients (71 eyes) met inclusion criteria. The mean age at surgery was 5.1 years. Mean refractive error change in all the operated eyes was a 0.82 D decrease in spherical equivalent (p = 0.1920) and a 0.40 D increase in cylinder (p = 0.0255). There were no statistically significant changes in spherical equivalent or cylinder in the control eyes.

CONCLUSIONS: The authors data did not show movement toward normalization of refractive error following ptosis surgery. In fact, it showed a statistically significant worsening of astigmatism following surgery. Because refractive error does not improve following surgery, anisometropia should not be the sole indication for early surgery in congenital ptosis.

Author List

Chisholm SAM, Costakos DM, Harris GJ

Authors

Smith Ann Meile Chisholm MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Deborah M. Costakos MD Chair, Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Gerald J. Harris MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Anisometropia
Blepharoptosis
Child
Child, Preschool
Decision Making
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Oculomotor Muscles
Operative Time
Ophthalmologic Surgical Procedures
Postoperative Period
Refraction, Ocular
Retrospective Studies
Treatment Outcome
Visual Acuity