{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:20:02Z","timestamp":1780100402363,"version":"3.54.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In this study, we aimed to evaluate the characteristics of astigmatism preoperatively and 1 month postoperatively in patients with age-related ptosis (AP) and contact lens-related ptosis (CLP), and investigate surgery-induced astigmatism (SIA) using the Jaffe vector analysis and the Cravy method. Consecutive patients who underwent blepharoptosis surgery between January 2019 and December 2019 were included. The patients were divided into AP and CLP groups. Computerized corneal topography was used to assess the magnitude and axis of corneal astigmatism. Astigmatism was classified as with-the-rule (WTR), against-the-rule (ATR), or oblique astigmatism (OA) pre- and postoperatively. SIA was calculated by vector analysis using the Cravy and Jaffe methods. The correlation between SIA and margin reflex distance (MRD) was calculated. One hundred and eight eyes from 58 patients (AP group: 85 eyes from 45 patients, CLP group: 23 eyes from 13 patients) were included. The AP group (73.8\u00b17.6 years) was significantly older than the CLP group (47.7\u00b16.6 years). The MRD increased significantly after treatment in both groups. The proportions of WTR, ATR, and OA were 52%, 22%, and 25%, and 86%, 9%, and 4% in the AP and CLP groups, respectively. A shift in astigmatism type was observed in 41% and 13% of patients in the AP and CLP groups, respectively. The average SIA measured using the Cravy method was 0.11\u00b11.22 D in the AP group and \u22120.28\u00b11.07 D in the CLP group (WTR astigmatism). The SIA calculated using the Jaffe method was 0.78\u00b10.70 D in the AP group and 0.82\u00b10.88 D in the CLP group. There was no significant correlation between SIA calculated using the Cravy and Jaffe methods and MRD. ATR was most common in age-related ptosis and WTR was most common in contact lens-related ptosis. Upper eyelid re-positioning may affect visual functions due to astigmatic changes in the short term postoperatively.<\/jats:p>","DOI":"10.1371\/journal.pone.0258688","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T17:26:36Z","timestamp":1635441996000},"page":"e0258688","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics of astigmatism before and 1 month after blepharoptosis surgery in patients with acquired ptosis"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5369-7882","authenticated-orcid":true,"given":"Kazuhiko","family":"Dannoue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Takei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7255-2184","authenticated-orcid":true,"given":"Tomohiko","family":"Usui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"pone.0258688.ref001","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s12886-020-01350-y","article-title":"Blepharoptosis among Korean adults: age-related prevalence and threshold age for evaluation","volume":"20","author":"JS Paik","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"pone.0258688.ref002","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/0002-9394(81)90065-9","article-title":"Acquired blepharoptosis secondary to contact lens wear","volume":"91","author":"G Epstein","year":"1981","journal-title":"Am J Ophthalmol"},{"key":"pone.0258688.ref003","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1159\/000085244","article-title":"Ptosis secondary to anterior segment surgery and repair in a two-year follow-up study","volume":"219","author":"M Altieri","year":"2005","journal-title":"Ophthalmologica"},{"key":"pone.0258688.ref004","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/archopht.1989.01070010862030","article-title":"Quantitating the superior visual field loss associated with ptosis","volume":"107","author":"DR Meyer","year":"1989","journal-title":"Arch Ophthalmol"},{"key":"pone.0258688.ref005","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/S0161-6420(93)31593-9","article-title":"Evaluating the visual field effects of blepharoptosis using automated static perimetry","volume":"100","author":"DR Meyer","year":"1993","journal-title":"Ophthalmology"},{"key":"pone.0258688.ref006","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/IOP.0000000000000307","article-title":"Contrast sensitivity testing in functional ptosis and dermatochalasis surgery","volume":"31","author":"BT Fowler","year":"2015","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"pone.0258688.ref007","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/00003226-200005000-00016","article-title":"Lids influence the corneal shape","volume":"19","author":"DM Lieberman","year":"2000","journal-title":"Cornea"},{"key":"pone.0258688.ref008","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12886-017-0426-2","article-title":"Effects of chalazia on corneal astigmatism: Large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism","volume":"17","author":"Ki Won Jin","year":"2017","journal-title":"BMC Ophthalmol"},{"key":"pone.0258688.ref009","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/0002-9394(77)90191-X","article-title":"Refractive errors associated with hemangiomas of the eyelids and orbit in infancy","volume":"83","author":"RM Robb","year":"1977","journal-title":"Am J Ophthalmol"},{"key":"pone.0258688.ref010","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/ICO.0b013e31818a7d61","article-title":"Eyelid pressure: inferences from corneal topographic changes","volume":"28","author":"AJ Shaw","year":"2009","journal-title":"Cornea"},{"key":"pone.0258688.ref011","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1038\/eye.1999.136","article-title":"Corneal topography in patients with congenital ptosis","volume":"13","author":"SH U\u011furba\u015f","year":"1999","journal-title":"Eye (Lond)"},{"key":"pone.0258688.ref012","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.ajo.2012.12.015","article-title":"Amblyopia in childhood eyelid ptosis","volume":"155","author":"GJ Griepentrog","year":"2013","journal-title":"Am J Ophthalmol"},{"key":"pone.0258688.ref013","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000381846","article-title":"The effect of ptosis on cataract surgical planning","volume":"6","author":"IC Kuo","year":"2015","journal-title":"Case Rep Ophthalmol"},{"key":"pone.0258688.ref014","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/00002341-199412000-00003","article-title":"Changes in refraction and keratometry after surgery for acquired ptosis","volume":"10","author":"MP Gingold","year":"1994","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"pone.0258688.ref015","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/00002341-199805000-00001","article-title":"Changes in astigmatism after ptosis surgery measured by corneal topography","volume":"14","author":"DE Holck","year":"1998","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"pone.0258688.ref016","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/00002341-199911000-00002","article-title":"Prospective analysis of changes in corneal topography after upper eyelid surgery","volume":"15","author":"MS Brown","year":"1999","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"pone.0258688.ref017","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1001\/archopht.125.12.1610","article-title":"Effect of upper eyelid surgery on corneal topography","volume":"125","author":"MS Zinkernagel","year":"2007","journal-title":"Arch Ophthalmol"},{"key":"pone.0258688.ref018","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/ICO.0000000000000729","article-title":"Corneal topographic changes after eyelid ptosis surgery","volume":"35","author":"G Savino","year":"2016","journal-title":"Cornea"},{"key":"pone.0258688.ref019","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1097\/SCS.0000000000002435","article-title":"Changes in corneal curvature after upper eyelid surgery measured by corneal topography","volume":"27","author":"YK Kim","year":"2016","journal-title":"J Craniofac Surg"},{"key":"pone.0258688.ref020","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1001\/archfaci.6.3.155","article-title":"Persistent blurred vision after blepharoplasty and ptosis repair","volume":"6","author":"W Shao","year":"2004","journal-title":"Arch Facial Plast Surg"},{"key":"pone.0258688.ref021","first-page":"OP615","article-title":"The pathophysiology of corneal astigmatism after cataract extraction","volume":"79","author":"NS Jaffe","year":"1975","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"pone.0258688.ref022","first-page":"38","article-title":"Calculation of the change in corneal astigmatism following cataract extraction","volume":"10","author":"TV Cravy","year":"1979","journal-title":"Ophthalmic Surg"},{"key":"pone.0258688.ref023","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/S0886-3350(13)80095-8","article-title":"Calculating the surgically induced refractive change following ocular surgery","volume":"18","author":"JT Holladay","year":"1992","journal-title":"J Cataract Refract Surg"},{"key":"pone.0258688.ref024","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S0955-3681(13)80208-0","article-title":"The longterm course of the surgically-induced astigmatism after a scleral tunnel incision","volume":"6","author":"M Dam-Johansen","year":"1994","journal-title":"Eur J Implant Refract Surg"},{"key":"pone.0258688.ref025","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S0886-3350(13)81018-8","article-title":"Conversion of keratometer readings to polar values","volume":"16","author":"K Naeser","year":"1990","journal-title":"J Cataract Refract Surg"},{"key":"pone.0258688.ref026","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0886-3350(00)00605-2","article-title":"Popperian falsification of methods of assessing surgically induced astigmatism","volume":"27","author":"K Naeser","year":"2001","journal-title":"Cataract Refract Surg"},{"key":"pone.0258688.ref027","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/S0886-3350(97)80021-1","article-title":"Vector analysis of astigmatism changes by flattening, steepening, and torque","volume":"23","author":"NAA Alpins","year":"1997","journal-title":"J Cataract Refract Surg"},{"key":"pone.0258688.ref028","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0886-3350(96)80203-3","article-title":"Multivariate analysis versus vector analysis to assess surgically induced astigmatism","volume":"22","author":"PJ Toulemont","year":"1996","journal-title":"J Cataract Refract Surg"},{"key":"pone.0258688.ref029","doi-asserted-by":"crossref","first-page":"e569","DOI":"10.1097\/SCS.0000000000001304","article-title":"Accuracy of marginal reflex distance measurements in eyelid surgery","volume":"26","author":"AY Nemet","year":"2015","journal-title":"J Craniofac Surg"},{"key":"pone.0258688.ref030","first-page":"320","volume-title":"Helmholtz\u2019s treatise on physiological optics","author":"A, H. Gullstrand","year":"1962"},{"key":"pone.0258688.ref031","doi-asserted-by":"crossref","first-page":"e12894","DOI":"10.1097\/MD.0000000000012894","article-title":"Age-related variations in corneal geometry and their association with astigmatism: Yamagata Study (Funagata)","volume":"97","author":"H Namba","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"pone.0258688.ref032","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.jcrs.2010.02.025","article-title":"Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes","volume":"36","author":"PC Hoffmann","year":"2010","journal-title":"J Cataract Refract Surg"},{"key":"pone.0258688.ref033","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.ophtha.2015.10.002","article-title":"Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis","volume":"123","author":"L Kessel","year":"2016","journal-title":"Ophthalmology"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0336805","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0258688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T17:27:04Z","timestamp":1635442024000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0258688"}},"subtitle":[],"editor":[{"given":"Ahmed","family":"Awadein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,10,28]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0258688","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,28]]}}}