AIM: To compare the changes of corneal shape and astigmatism before and after surgery in children with congenital ptosis in different degrees and different ages, and to provide a certain clinical basis for the timing of ptosis surgery and the time of refractive correction.

METHODS: The study consisted of 83 patients(114 eyes, 52 cases in one eye and 31 cases in both eyes)who were diagnosed with congenital ptosis and received frontalis muscle aponeurosis in our hospital from September 2015 to August 2016. The corneal topography and retinoscopy results were collected before and 1, 3, and 6mo after surgery. Corneal topography and 10g/L atropine ophthalmic gel retinoscopy were performed on all subjects, and the changes in the amount of astigmatism before and after surgery were compared between different degrees, different age groups, and different follow-up periods.

RESULTS: The corneal astigmatism measured by corneal topography after moderate to severe ptosis was not statistically different from that before the operation(P>0.05). In the 3 to less than 5 year old age group, cases with moderate to severe ptosis was observed after 6mo of Cyl, C value decrease compared with preoperative. In 5 to less than 12 year old age group, Cyl increased at first then decreased gradually 1mo after surgery compared with preoperative in patients with moderate ptosis, and decreased lower after surgery in 6mo, but C value increased compared with preoperative. In patients with severe ptosis, Cyl values showed a gradual decline after a significant increase in 1mo postoperatively, no significant changes compared with before surgery at 6mo, but the C value increased compared with preoperative.

CONCLUSION: Patients with congenital ptosis with 3 to less than 5 years of age undergo surgical treatment. The postoperative astigmatism has a large decrease, which is a suitable age for operation. The early astigmatism changes greatly after ptosis and it is recommended to increase the follow-up frequency and perform refractive correction in time.