Abstract:AIM:To investigate the refractive status and axial length in patients with mild to moderate congenital ptosis coexisting concomitant exotropia.
METHODS:In this prospective observational study, we divided all patients between September 2011 and February 2021 into three groups: 18 patients with mild to moderate congenital ptosis coexisting concomitant exotropia(CPE), 19 patients with mild to moderate simple congenital ptosis(CP)and 30 patients with simple concomitant exotropia(CE). All subjects underwent ocular examinations, including axial length, and cycloplegic refraction. The prevalence of refractive errors, amblyopia, spherical power, astigmatism, spherical equivalent, and axial length were compared between CPE, CP and CE.
RESULTS:Ptosis occurred mostly in both eyes in CPE group about 17 cases(94%), but mostly in one eye in CP group about 13 cases(69%), with a significant difference between the two groups(χ2=15.531, P<0.001). There were significant differences in the prevalence of anisometropia(χ2=8.732, P=0.013)and myopia(χ2=6.047, P=0.049)among the three groups. The prevalence of anisometropia(χ2=8.072, P=0.004)and myopia(χ2=4.555, P=0.033)was higher in CPE than CP, while there was no significant difference in the prevalence of anisometropia(χ2=0.559, P=0.454)and myopia(χ2=0.055, P=0.815)between the CPE and CE. The spherical power(χ2=-31.143, P=0.002), myopic astigmatism(χ2=-23.434, P=0.028)and spherical equivalent(χ2=-30.137, P=0.003)of CPE were a higher refractive error and axial length(χ2=26.289, P=0.012)was longer than those in the CP, but there was no significant difference with the CE. In young group, the spherical power of the CPE was a higher refractive error than that of CE(χ2=-16.831, P=0.016), and the spherical equivalent of the CPE was a higher refractive error than that of CP(χ2=-18.391, P=0.020).
CONCLUSION:Mild to moderate congenital ptosis coexisting concomitant exotropia exacerbates the development of axial myopia, myopic astigmatism, and anisometropia, which is more severe than sample ptosis. Therefore, early ophthalmic evaluation and timely surgical treatment may prevent the visual acuity of damage caused by CPE.
