title: Clinical evaluation of refractive changes following brow suspension surgery in pediatric patients with congenital blepharoptosis.
abstract: OBJECTIVE
  To evaluate the postoperative visual acuity and refractive changes occurring after bilateral frontalis brow suspension surgery in pediatric patients with congenital blepharoptosis.
  
  
  METHODS
  Twenty-three patients between 4 and 12 years old with severe congenital blepharoptosis (unilateral in 21 cases and bilateral in 2 cases; total of 25 eyes) and poor levator function underwent bilateral frontalis brow suspension surgery by Crawford's double triangle method with 4:0 expanded polytetrafluoroethylene sutures. The non-ptotic eyes (21 eyes) undergoing frontalis brow suspension surgery served as the control group. All patients had best-corrected spectacle visual acuity (BCSVA) of more than 6/9 preoperatively in both eyes. Changes in the postoperative BCSVA, binocularity, relevant refractive parameters, lid position, lagophthalmos, lid lag, and tear break-up time were evaluated in both groups for 12 weeks and appropriate statistical tests were applied.
  
  
  RESULTS
  Significant differences were found in the baseline characteristics and the postoperative changes in the eyes with and without ptosis. However, these were found to be transient and did not result in any new cases of amblyopia postoperatively. No complications requiring revision of surgery were seen.
  
  
  CONCLUSIONS
  The changes in the BCSVA after frontalis brow suspension surgery are transient. Retinoscopy, manual keratometry, and corneal videokeratoscopy are simple and effective methods to evaluate the sequential refractive changes occurring in these eyes.
authors.affiliation: Guru Nanak Eye Center, Maulana Azad Medical College, University of Delhi, New Delhi, India.
authors.forename: Sushil
authors.initials: S
authors.lastname: Kumar
authors.forename: Zia
authors.initials: Z
authors.lastname: Chaudhuri
authors.forename: Deepender
authors.initials: D
authors.lastname: Chauhan
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology