Abstract / Summary
To evaluate changes in anterior segment morphology using anterior segment optical coherence tomography (AS-OCT) in patients undergoing levator surgery for ptosis and to investigate the potential influence of eyelid position changes on anterior segment parameters. This study included 20 eyes of 18 patients who underwent levator surgery for ptosis. Eyelid parameters (MRD-1 and palpebral fissure height) and anterior segment measurements obtained by AS-OCT were recorded preoperatively and at postoperative weeks 4–6. Angle opening distance (AOD), trabecular iris space area (TISA), iridocorneal angle (ICA), Schlemm canal length (SCL), and Schlemm canal area (SCA) were measured in nasal and temporal quadrants. Postoperatively, MRD-1 and PFH increased statistically significantly ( p < 0.001 for both). Among anterior segment parameters, a significant postoperative decrease was observed only in nasal SCL ( p = 0.008), with a moderate-to-large effect size ( r = 0.419). No significant differences were detected in AOD, TISA, ICA, or SCA measurements in either nasal or temporal quadrants ( p > 0.05). Nasal ICA demonstrated a borderline postoperative increase ( p = 0.086; r = 0.271). Correlation analysis revealed a significant negative association between nasal AOD change and both MRD-1 and PFH changes. Levator surgery for ptosis may be associated with subtle anterior segment morphologic changes detectable by AS-OCT. In particular, the observed decrease in nasal SCL should be regarded as an exploratory, hypothesis-generating finding that requires confirmation in larger studies.