目的：探讨单侧先天性上睑下垂患儿的眼部生物学参数和屈光状态的差异。

方法：回顾性队列研究，对2018年8月至2025年3月间在西安市儿童医院眼科就诊的单侧先天性上睑下垂患者进行研究，对侧健眼作为对照组。对所有患儿均进行详细的眼科检查，评估上睑下垂的程度，检查屈光不正，并使用IOL Master 700生物测量仪进行眼部生物学测量，包括眼轴长度(AL)、角膜中央厚度(CCT)、前房深度(ACD)、晶状体厚度(LT)、散光(AST)等眼部参数。

结果：纳入单侧先天性上睑下垂患者100例100眼(患眼组)，并将100只对侧无上睑下垂的健眼作为对照组(健眼组)。其中男67例(67%)，女33例(33%)，平均年龄6.43±2.47岁； 患眼为右眼45眼，左眼55眼，100例患者中轻度、中度、重度上睑下垂分别占比为7%、21%、72%。单侧先天性上睑下垂患者弱视发生率32%，均为患眼。患眼组与健眼组相比，K2(总)和K2(重度上睑下垂)更低(P<0.05)，说明上睑下垂眼的角膜更平坦； 中度上睑下垂患者中患眼与健眼相比CCT更高(P<0.05)，说明中度上睑下垂眼的角膜厚度更厚。逆规及斜轴散光发生率患眼组(39%)明显高于健眼组(14%)； 患眼组与健眼组的角膜散光轴向有显著性差异(P<0.01)。患眼与健眼的屈光状态及生物学参数如AL、K1、AST、ACD、LT均无差异。

结论：先天性上睑下垂会影响屈光不正，导致斜轴及逆规散光的产生，增加弱视的患病率，还会导致角膜变厚、变平； 先天性上睑下垂对AL、LT、ACD的影响较小。

METHODS:This was a retrospective cohort study enrolling patients with unilateral congenital ptosis in the Department of Ophthalmology, Xi'an Children's Hospital between August 2018 and March 2025, with the contralateral healthy eyes serving as the control group. All patients underwent a detailed ophthalmic examination to assess the degree of ptosis and evaluate refractive errors. Biometric measurements were performed using the IOL Master 700 biometer, including axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), and astigmatism(AST).

RESULTS:A total of 100 eyes from 100 children(affected eye group)with unilateral congenital ptosis were enrolled, and their 100 contralateral normal eyes without ptosis were set as the control group(healthy eyes group). Among the subjects, there were 67 males(67%)and 33 females(33%), with a mean age of 6.43±2.47 y; 45 affected eyes were the right eye and 55 were the left eye. Among the 100 patients, mild, moderate, and severe ptosis accounted for 7%, 21%, and 72%, respectively. The incidence of amblyopia in patients with unilateral congenital ptosis was 32%, all of which occurred in the affected eye. Compared with the healthy eye group, K2(total)and K2(severe ptosis)in eyes with severe ptosis were significantly lower(P<0.05), indicating that the cornea in the ptotic eye was flatter. In patients with moderate ptosis, the affected eye had a significantly greater corneal thickness(CCT)compared to the healthy eye(P<0.05), indicating that the corneas of eyes with moderate ptosis were thicker. The incidence of against-the-rule and oblique astigmatism in the affected eye group(39%)was significantly higher than that in the healthy eye group(14%); there was a significant difference in the corneal astigmatism axis between the affected and healthy eye groups(P<0.01). There were no differences in refractive status or biological parameters such as AL, K1, AST, ACD, and LT between the affected and healthy eyes.

CONCLUSION:Congenital ptosis can affect refractive errors, lead to oblique and against-the-rule astigmatism, increase the prevalence of amblyopia, and also result in corneal thickening and flattening. However, it has minimal effects on AL, LT, and ACD.