Changes in Astigmatism after Surgical Repair of Epiblepharon or Ptosis: A Vectorial-analytic Approach

ABSTRACT

PURPOSE: To analyze the changes of astigmatism and keratometric cylinder by using the scalar and vector analysis method in children who had undergone surgery for epiblepharon or ptosis. METHODS: The study subjects were 142 eyes of 79 patients who had undergone surgery for epiblepharon or ptosis. We examined the cycloplegic refractive error and keratometric astigmatism by auto-refractometry before and 2 months after surgery. Astigmatic changes were analyzed through the scalar and vector analysis method. RESULTS: The mean age of the patients was 5.27+/-2.18 years of age, and the male to female ratio was 35 44. There were 98 eyes of 49 patients in the epiblepharon surgery group, 28 eyes of 22 patients in the ptosis surgery group, and 16 eyes of 8 patients in the epiblepharon and ptosis surgery (combined surgery) group. The epiblepharon surgery group demonstrated a decrease in with-the-rule astigmatism, and the changes in magnitude (p<0.001) and vector (p<0.05) of keratometric cylinder were statistically significant. The ptosis surgery group demonstrated an increase in with-the-rule astigmatism and the changes in magnitude and vector of astigmatism were statistically significant (both p<0.01). The combined surgery group demonstrated an increase in with-the-rule astigmatism and the changes in vector of astigmatism and magnitude of keratometric cylinder were statistically significant (both p<0.05). CONCLUSIONS: Our results showed significant astigmatic change in eyes that underwent surgery for epiblepharon or ptosis. Therefore, careful cycloplegic refraction is necessary after epiblepharon or ptosis surgery.