Changes Of Corneal Morphology And Astigmatism In Children With Congenital Ptosis Before And After Operation

Objective: Through the comparison of moderate and severe congenital ptosis in children with preoperative and postoperative astigmatism correction difference degree and different age stages of operation at different time after astigmatism changes,the time for surgery of the upper eyelid ptosis,postoperative refractive correction time to provide clinical basis.Subjects and Method:The object of study was the 83 cases of patients(114 eyes,52 eyes of unilateral cases and two eyes of 31 cases)from September 2015-August 2016,collected the corneal topography and retinoscopy results before and after the operation in 1month,3months,6months.According to the age and the degree of ptosis were divided into 4 groups: 1)3 ~ 5 moderate blepharoptosis group;2)from 3 to 5 years old with severe ptosis group;3)5 ~ 12 moderate blepharoptosis group;4)from 5 to 12 years old with severe ptosis were performed on all patients group.All the patients underwent corneal topography,1% atropine eye gel after mydriasis retinoscopy examination,according to the above groups collected data,comparative analysis of different degree of ptosis preoperative astigmatism,different degrees of postoperative astigmatism,different age,different follow-up time.Using SPSS18.0 for statistical analysis,analysis of variance and(2 test,rank sum test was used for data analysis.Results: Preoperative:1.the same age with different degree of ptosis,corneal topography measured by corneal astigmatism(Cylinder,Cyl),surface regularity index(Surface Regularity,Index,SRI),the surface asymmetry index(Surface Asymmstry,Index,SAI)and retinoscopy total scattered light value(Concave-cylinder,C)no difference statistical significance(P > 0.05);2.the same degree of different age astigmatism value,corneal topography measured by Cyl,SRI,SAI and retinoscopy C were no significant difference(P > 0.05);3,/two age preoperative corneal topography results showed that with the increase of age,against the rule and oblique astigmatism to increase the proportion,the difference was statistically significant(P < 0.05);4.moderate ptosis eyes WR astigmatism 37%,against the rule astigmatism,oblique astigmatism 37%;severe ptosis eyes against the rule astigmatism 11.7%,oblique astigmatism 22.3%,the difference was statistically significant(P < 0.05);5.Cyl and C value was not statistically significant(P > 0.05).After the operation: 1.postoperative Moderate and severe ptosis after operation in January,March,June,to the direction of corneal astigmatism corneal topography measurement compared with preoperative difference was not statistically significant(P > 0.05);2.in the 3 to 5 year old age group,moderate and severe ptosis and C Cyl before and after operation decreased compared with the preoperative value;5 to 12 year old age group,moderate ptosis Cyl,C value 1 months after operation was significantly higher than before surgery decreased gradually after 6 months after the operation was lower than that before treatment;severe ptosis postoperative Cyl was significantly increased after decreased gradually after 6 months than before no significant change,but C value higher than before surgery.Conclusion:1.Proportion of oblique astigmatism and astigmatism against the rule in the children with congenital ptosis was increasing,ptosis degree was not related to.2.3 ~ 5 years old underwent surgery,a larger proportion of decreased postoperative astigmatism,the incidence of amblyopia can reduce 3.3 ~ 5 and 5 ~ 12 years old moderate severe ptosis postoperative changes early astigmatism larger,proposed to increase the frequency of follow-up,timely correction.