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Title: Analysis of Corneal Topographic Changes after Upper Lid Surgery in Congenital and Acquired Ptosis
Authors: Maryam Nisar, Abid Hassan Naqvi, Muhammad Shahid Tarar, Nisar Ahmed Khan, Summaya Khan, Amna Khan
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2023
Volume: 73
Issue: 5
Language: English
Keywords: Acquired ptosisCongenital ptosisCorneal topographic changesUpper lid surgery
Objective: To assess the corneal topographic and refractive changes after ptosis surgery.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jan 2020 to Jul 2021.
Methodology: A total of 90 individuals were selected by non-probability convenience sampling. Patients with diagnosed Ptosis and planned for surgery were followed up for six months post-surgery. Corneal topography, visual acuity, and physical assessment for Ptosis were done pre and post-surgery and compared for differences.
Result: There were more cases of acquired Ptosis than congenital in our sample (p=<0.001). The patients had more poor levator function pre-operatively (p=0.291), which improved to fair post-operatively (p=<0.0001). Post-operatively, a significant decrease in the SimK and Cylinder power was observed in the sample. The visual acuity improved significantly, and the MRD also improved. With no significant change in CCT post-operatively.
Conclusion: Our study showed that post-surgery SimK, visual acuity, MRD, and cylindrical power improved. However, the CCT did not show significant alterations.
To assess the corneal topographic and refractive changes after ptosis surgery.
Prospective longitudinal study involving 90 individuals with diagnosed ptosis planned for surgery. Corneal topography, visual acuity, and physical assessment for ptosis were performed pre- and post-surgery (six months follow-up). Data was analyzed using SPSS version 23 with paired sample t-test and Chi-square test.
graph TD;
A["Participant Selection n=90"] --> B["Pre-operative Assessment: Corneal Topography, Visual Acuity, Physical Assessment"];
B --> C["Ptosis Surgery"];
C --> D["Post-operative Assessment: Corneal Topography, Visual Acuity, Physical Assessment"];
D --> E["6-Month Follow-up Assessment"];
E --> F["Data Analysis: Paired t-test, Chi-square test"];
F --> G["Conclusion and Interpretation"];
The study suggests that ptosis surgery leads to improvements in corneal topographic parameters, visual acuity, and MRD. While some studies show similar findings, others report contrary results, potentially due to shorter follow-up periods or specific surgical techniques. The pressure of the eyelid in ptosis may induce corneal steepening, which is reversed with surgical correction.
Post-operatively, a significant decrease in SimK (Simulated Keratometry) and Cylinder power was observed. Visual acuity and Marginal Reflex Distance (MRD) improved significantly. Central Corneal Thickness (CCT) did not show significant alterations. Acquired ptosis was more prevalent than congenital ptosis. Levator function improved post-operatively.
Ptosis surgery significantly improves SimK, visual acuity, MRD, and cylindrical power, while CCT remains largely unchanged. Further research is needed to elaborate on these parameters and optimize recovery from refractive errors caused by ptotic eyelids.
- A total of 90 individuals were included in the study. (Confirmed in Results section)
- The study was conducted from January 2020 to July 2021. (Confirmed in Methodology section)
- Post-operatively, SimK showed a significant decrease (p=0.04). (Confirmed in Table-III)
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