ABSTRACT
PURPOSE: To evaluate the corneal topography and aberrometry and their changes following ptosis surgery in patients suffering from unilateral congenital blepharoptosis. METHODS: The study included 15 eyes of 15 patients with unilateral congenital blepharoptosis who underwent surgical correction through anterior levator resection. Shack-Hartmann wavefront sensor was employed to assess Zernike coefficients and root-mean-square. Computerized corneal topography, Orbscan and aberrometry were measured pre-and 3 months post-surgery in the healthy and ptotic eyes. Aberrometric changes were compared between patients with more than one diopter of astigmatism and subjects with less amount of astigmatism. Data were analyzed using the SPSS version 16. P < 0.05 was considered as significance level. RESULTS: Following anterior levator resection, the amount of astigmatism decreased. However, the difference was not statistically significant. Changes in topographic indices were not statistically significant. Regarding tomographic indices, the change in minimum keratometry was significant. The amount of change in total higher-order aberrations (HOAs) was not statistically significant. However, there was a decrease in the amount of third-order aberrations (vertical coma and vertical trefoil) which was statistically significant for vertical coma (-0.002 ± 0.001 vs. -0.08 ± 0.02 µm, P = 0.02). Comparing aberrometric changes in patients with more than 1 diopter astigmatism and less, there was a significant difference in the amount of HOA w/o Z400. CONCLUSION: Surgical correction of ptosis could reduce the ocular aberrations, despite no significant change in astigmatism. Nonaxial high-order aberrations are mostly affected probably due to the meridional effect of ptosis on the cornea.
ABSTRACT
PURPOSE: To evaluate the histopathologic changes in the conjunctiva of patients with conjunctivochalasis (CCh) compared to age-matched controls. METHODS: This cross-sectional, controlled study included 27 eyes of 27 patients with CCh and 16 eyes of 16 age-matched controls. A biopsy of the bulbar conjunctiva was performed along the temporal lower lid margin before cataract surgery in both groups. Histopathologic evaluation of the specimens was done with light microscopy using staining with hematoxylin/eosin, periodic acid Schiff, and van Gieson elastic stain. Various histopathologic features of the conjunctival epithelium and stroma were compared between the two groups. RESULTS: The mean age of patients was 62.4 ± 6.9 years in the CCh group and 65.1 ± 6.3 years in the control group (P = 0.54). No significant differences were noted between the two groups in terms of conjunctival epithelial changes including papillomatosis, epithelial clefts, epithelial goblet cells, or infiltration of inflammatory cells. Mean thickness of the conjunctival stroma was 0.21 ± 0.08 mm in the CCh group and 0.26 ± 0.21 mm in the control group (P = 0.10). For the conjunctival stroma, there were no significant differences between the two groups in terms of elastosis, fibrosis, lymphangiectasia, or infiltration of inflammatory cells. CONCLUSION: No noticeable differences were found in the histopathologic features by light microscopy between eyes with CCh and those of age-matched controls. Therefore, the primary pathology of CCh may not be within the conjunctiva itself. Instead, loose attachment of the conjunctiva to the underlying tissue may be the reason for the redundant folds in the bulbar conjunctiva.
