Zinkernagel Martin S, Ebneter Andreas, Ammann-Rauch Dagmar
Department of Ophthalmology, Cantonal Hospital St Gallen, Rorschacherstrasse, St Gallen 9007, Switzerland.
Arch Ophthalmol. 2007 Dec;125(12):1610-2. doi: 10.1001/archopht.125.12.1610.
To compare the effects of different upper eyelid procedures on corneal topography.
Eighty-two eyes of 43 patients with various degrees of dermatochalasis or ptosis underwent computed corneal topography before surgery and at 3 months after surgery. Patients were divided into groups depending on the extent of surgery. In addition, the thickness of the central cornea was correlated with the change in astigmatism.
There were mean changes in total astigmatism of 0.25 diopter (D) after ptosis surgery (P = .02) and 0.21 D after blepharoplasty with reduction of large fat pads (P = .04) compared with 0.09 D in patients after skin-only blepharoplasty. In addition, there was a correlation between corneal thickness and change in astigmatism of more than 0.2 cylinders after ptosis surgery (P < .05). Postoperative astigmatic axis changes were not systematic.
We found a statistically significant correlation between the severity of upper eyelid abnormality and topographical corneal changes after surgery. These findings emphasize the importance of advising patients, especially those with ptosis and severe dermatochalasis, that upper eyelid repositioning procedures may induce vision changes.
比较不同上睑手术对角膜地形图的影响。
43例不同程度皮肤松弛或上睑下垂患者的82只眼在手术前及术后3个月接受了计算机角膜地形图检查。根据手术范围将患者分组。此外,将中央角膜厚度与散光变化进行关联分析。
上睑下垂手术后总散光平均变化0.25屈光度(D)(P = 0.02),去除大量脂肪垫的眼睑成形术后为0.21 D(P = 0.04),而单纯皮肤眼睑成形术后患者为0.09 D。此外,上睑下垂手术后角膜厚度与超过0.2柱镜的散光变化之间存在相关性(P < 0.05)。术后散光轴变化无系统性。
我们发现上睑异常的严重程度与手术后角膜地形图变化之间存在统计学上的显著相关性。这些发现强调了告知患者的重要性,尤其是那些患有上睑下垂和严重皮肤松弛的患者,上睑复位手术可能会引起视力变化。