Blepharoptosis Surgery May Lead to Greater Axial Change in Corneal Astigmatism

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.

Outcomes

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).

Limitations

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.