Incidence of congenital heart diseases in Chinese children with non-syndromic congenital blepharoptosis:a prospective observational study of 1053 patients

Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenital heart diseases(CHD)in CBP children not associated with specific syndromes.Methods A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography.Results Forty children were identified with CHD.Twenty-four children had one type of structural malformation(simple CHD).Sixteen children had two or more types of structural malformation(complex CHD).CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis.Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence.Conclusions We found an increased frequency of CHD in CBP children,suggesting a clinical need for routine echocardiography evaluation in CBP,especially in children with severe or bilateral ptosis.

The inflammation influence on corneal surface after frontalis suspension surgery

AIM： To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines.METHODS： A prospective, observational case series. Thirty-one eyes of 25 patients with severe congenital blepharoptosis who underwent frontalis muscle flap suspension surgery with at least 6 mo of follow-up were included in the study. The main outcome measures were margin reflex distance 1（MRD_1）, degree of lagophthalmos, ocular surface disease index（OSDI）, fluorescein staining（Fl）, tear break-up time（BUT）, Schirmer I test, and inflammatory cytokine assay.RESULTS： The degrees of lagophthalmos significantly increased after surgery. The OSDI scores significantly increased 1wk postoperatively and then decreased 4wk after operation. The Fl scores reflected corneal epithelial defects in sixteen patients at early stage postoperatively. The BUT and Schirmer I test values remained stable and did not show change compared to those before surgery. The inflammatory cytokines in conjunctival epithelial cells（including IL-1β, IL-6, IL-8, TNF-α, and IL-17A） significantly increased 1wk after the surgery（P〈0.001）, then returned to the normal level at 24wk postoperatively. The levels of inflammatory cytokine IL-1β, IL-6, IL-8, TNF-α, and IL-17A elevated significantly and were positively correlated with OSDI and Fl scores.CONCLUSION： Frontalis muscle flap suspension surgery results in lagophthalmos in early period of post-operation and relieved after months. The elevation of inflammatory cytokines level may participate in the occurrence of corneal epithelial defects at the early postoperative stage.