ABSTRACT
·AIM: To investigate the ocular surface and refractive change after the surgery of levator resection and frontalis suspension. ·METHODS:One hundred and twenty-one patients (146 eyes) for corrective surgery of congenital ptosis were selected in our department from July 2014 to June 2016. According to the severity of congenital ptosis, all the children divided into mild group (47 eyes), moderate group (68 eyes) and severe group(31 eyes). All the children were divided into group of less than 5 years old (104 eyes) and group of more than or equal to 5 years old (42 eyes) according to the age. According to the surgical approach, all the children divided into group of levator resection (62 eyes) and group of frontalis suspension(84 eyes). The effects of the two surgeries on the ocular surface and refractive were compared. The relationship between age, severity of postoperative ptosis and postoperative ocular surface, refractive of children were analyzed. ·RESULTS: There were no significant differences in break-up time (BUT), keratometry (Km) and corneal astigmatism (Ast) in the levator resection group and frontalis suspension group (P > 0. 05). There was significant difference between the mild, moderate and severe group on the proportion of excellent corrected to uncorrected (Z=-2.936, P=0.003). The proportion of excellent correction in mild group was higher than that of moderate and severe group(93.6%, 83.8% and 67.7%). The indexes of BUT (F=9.793, P=0.041) and Km (F=11.657,P=0.037) in the three groups decreased with the increase of severity. While the Ast (F=28.417, P<0.01) showed an increasing trend, the difference was significant. In addition, the proportion of excellent correction in <5 year old group was significantly more than≥5 years old group(x2=4.082,P=0.043). The index of Km (t= 2.813, P= 0.006) was higher and Ast (t=-7.741, P<0.01) was lower in the <5 year old group. There was no significant difference in the index of BUT between the two groups after surgery (P>0.05). · CONCLUSION: The corneal refractive power and astigmatism can be improved similarly after treated with levator resection and frontalis suspension surgery. And there is some damage of corneal epithelial in the initial postoperation, but the function of ocular surface can return to normal after a period of time. The less severity of ptosis before surgery,the better improvement of ocular surface and refractive after sugery. There is no correlation between the age and postoperative ocular surface, but earlier surgical treatment may improve the children's refractive power and astigmatism and achieve greater benefits.
ABSTRACT
AIM:To observe the incidence of ocular fundus disease in preschool children examined by non-mydriatic fundus camera and evaluate its effectiveness compared with direct inspection shadow mirror. METHODS: Three thousand eight hundred and ninety-six preschool children from April 2012 to October 2013 were examined by Topcon TRC-NW300 color fluorescence fundus camera and direct inspection shadow mirror, and images were saved immediately. RESULTS: Detection rate of non - mydriatic fundus photography was higher than that of direct inspection shadow mirror. In 3 896 cases, 41 eyes were detected abnormal fundus accounting for 1. 05%. The retinal myelinated nerve fibers, morning glory syndrome, retinitis pigmentosa, congenital retinoschisis were common, accounted for 24. 39%, 21. 95%, 14. 63%, 12-20% respectively. The children eye diseases were often accompanied by abnormal vision (68. 30%), ametropia (63. 41%), strabismus (19. 51%). CONCLUSION:Non-mydriatic fundus photography is a mydriatic method without medicine, so it is easy for preschool children to accept. Image results could directly display the fundus lesions. It shows important significance in the screening for preschool children eye diseases.