Corneal Topographic Changes after Surgery in Epiblepharon Children

PURPOSE: This study was designed to evaluate the postoperative changes of astigmatism and corneal refractive power after surgical correction of epiblepharon using computerized topography. METHODS: The surgical data were investigated retrospectively before surgery and 1 month, 3 month after surgery in 23 patients who had undergone surgery for epiblepharon. We evaluated 8 points of the corneal refractive index, the corneal center and nasal, temporal, inferior 1.0 and 2.0 mm and superior 1.0 mm respectively. And the incidences and types of astigmatism were evaluated before and after surgery. RESULTS: After surgery, we observed corneal flattening at all points according to corneal topography, but corneal refractive changes were statistically insignificant except for inferior 1.0mm point (P< 0.05). Mean astigmatism was decreased after surgery and statistically significant 3 month after surgery (P< 0.05). Mean corneal refractive change on vetical meridian was prominent compared to horizontal meridia and statistically significant 3 month after surgery (P< 0.05). CONCLUSIONS: In epiblepharon, children corneal topographic changes were observed due to reduction of corneal irritation and pressure by cilia and lower eyelid after surgery. Astigmatic changes were progressed 3 month after surgery and with-the-rule astigmatism was observed mainly before and after surgery. But corneal refractive changes were prominent on vertical meridian, and therefore there was a tendency toward improvement of with-the-rule astigmatism.

The Relationship between Binocular Function and the Surgical Outcome of Intermittent Exotropia

PURPOSE: This study was designed to determine the relationship between binocular function and the surgical outcome of intermittent exotropia. METHODS: The surgical outcome and binocular function were retrospectively investigated in 44 patients who had undergone surgery for intermittent exotropia with at least 6 months of post-operative follow-up. We evaluated visual acuity, age at operation, angle of exodeviation, fusional status with Worth-4-dot test and stereoacuity with Titmus test before and after surgery. RESULTS: A 'surgical success' defined as a final alignment of orthophoria, esotropia less than 5PD or exotropia less than 10PD at far primary position, was achieved in 31 patients (70%). The surgical outcome according to preoperative stereopsis and fusional status was not statistically significant. Whereas, there was a tendency toward more surgical success in patients with central fusion and the first postoperative day diplopia but statistically indifferent. There was an improvement of stereoacuity in 34 out of 44 patients after surgery. The fusional status was improved in 9 patients out of 44 patients. There was an improvement of postoperative binocular function regardless the surgical outcome. But the achievement of fine stereopsis below 100 seconds of arc and central fusion increased only in success group. CONCLUSIONS: The preoperative binocular function did not contribute significantly to the surgical outcome (p>0.05) and postoperative binocular function could be improved by surgical correction in both surgical success and failure group. But the better binocular function was achieved by successful surgical alignment.