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  • Cornea/External Disease, Oculoplastics/Orbit

    Review of: Significant changes of corneal astigmatism after levator muscle surgery for acquired blepharoptosis

    Chen P-J, Lee Y-K, Lai C-C. Ophthalmic Plastic and Reconstructive Surgery, in press 2024

    Changes in corneal astigmatism were found to be pronounced in some patients who had surgery for blepharoptosis, particularly those with more severe disease.

    Study Design

    In this retrospective cohort study conducted at a single center in Taiwan, astigmatism measurements were assessed preoperatively and at least 1 month after surgery in 68 patients (120 eyes) who underwent levator surgery for acquired blepharoptosis.


    Post-surgery, the mean axial change of corneal astigmatism from baseline was 17.4 degrees, a significant difference, and 46% of patients experienced at least 10 degrees of change. Patients with more severe blepharoptosis (margin to reflex distance1 <1 mm) experienced greater mean change than patients with less severe blepharoptosis (22.7 vs 12.0 degrees, respectively).


    The duration of follow-up varied among patients, and the study population was relatively small. Additionally, while the authors assessed astigmatism, they did not specifically comment on visual acuity.  Future studies may wish to focus on the change of astigmatism over time.

    Clinical Significance

    This information may be helpful when counseling patients about the nature of blepharoptosis surgery and addressing postoperative concerns regarding vision. Patients with moderate-to-severe blepharoptosis should be advised that they may develop a change in their astigmatism.

    Financial Disclosures: Dr. Edward Wladis discloses financial relationships with FuzeHub, Lions Eye Foundation (Grant Support) and Horizon Therapeutics (Consultant/Advisor; Lecture Fees/Speakers Bureau), and is a patent holder.