목적 : 선천눈꺼풀처짐 교정술 후 발생한 난시 변화 및 수술 방법에 따른 난시발생 정도의 차이, 수술 후 부등시, 약시의 발생에 대해 알아보고자 하였다. 대상및 방법 : 선천눈꺼풀처짐을 진단받고, 이마근걸이 및 눈꺼풀올림근 절제술을 시행 받았던 환자 51명 102안을 대상으로 하였다. 모든 환자에서 수술전과 수술 후 3～6개월째 굴절검사 또는 조절마비굴절검사를 시행하여 난시 변화를 측정하였다. 수술 전, 후 눈꺼풀처짐 교정술 시행안과 정상안 사이의 난시 정도와 난시 변화를 비교하였고, 수술방법에 따른 난시 변화를 서로 비교하여 보았다. 결과 : 선천눈꺼풀처짐을 진단 받은 환자에서 수술전과 수술 후 눈꺼풀처짐안의 난시 정도는 각각 1.33±1.29D와 1.48±1.13D 였고(P=0.10), 수술 전후 난시 변화는 눈꺼풀처짐안과 정상안에서 +0.56±0.55D와 +0.68±0.72D의 증가를 보였다(P=0.37). 수술방법 간의 난시 변화는 이마근걸이 +0.57±0.67D, 눈꺼풀올림근 절제술 +0.56±0.50D로 통계적 유의성은 없었다(P=0.97). 수술 후 3명에서 난시 증가로 새로운 부등시가 발생하였으며 새로운 약시발생은 없었다. 결론 : 눈꺼풀처짐 교정술로 인한 유의한 난시 증가는 없었으며, 수술방법 간에도 유의한 차이가 없었다. 하지만, 수술안에서의 난시 증가로 부등시가 발생할 수 있으므로, 저 연령군에서는 약시예방을 위해 수술 후 굴절이상에 대한 주의 깊은 경과관찰이 필요할 것으로 사료된다.

Purpose: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. Methods: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. Results: The mean astigmatism was 1.33±1.29D preoperatively and 1.48±1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56±0.55D and +0.68±0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57±0.67D which was similar to those who received levator resection (+0.56±0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. Conclusions: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.

Purpose: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. Methods: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. Results: The mean astigmatism was 1.33±1.29D preoperatively and 1.48±1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56±0.55D and +0.68±0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57±0.67D which was similar to those who received levator resection (+0.56±0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. Conclusions: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.

Amblyopia, Anisometropia, Astigmatism, Congenital ptosis