Abstract
Purpose :
To analyze early ophthalmic changes following endoscopic surgery in infants with non-syndromic craniosynostosis. We hypothesize that early intervention in craniosynostosis improves concurrent ophthalmic abnormalities.
Methods :
This is a prospective cohort study to evaluate ophthalmic parameters in infants between the ages 0 and 12 months with non-syndromic craniosynostosis before and after surgery since 2019 by a single craniofacial team. 116 patients underwent complete eye examination with retina photos. 72 patients returned for postoperative examination. Ophthalmic parameters include optic nerve color, presence of disc edema, tortuosity, and dilatation of vessels in the retina. We also examined astigmatism and strabismus.
Results :
Of the 116 patients measured preoperatively, 51 patients had metopic craniosynostosis, 38 had sagittal, 23 had coronal, and 4 had lambdoid craniosynostosis. Initially, 62 patients had dilatation of vessels, 53 had disc edema, 28 had tortuous vessels, and 11 had abnormal coloration of the optic nerve. 72 patients had at least one follow up evaluation, in which all ocular parameters measured improved across all age groups. This trend was most noticeable when patients underwent surgery before the age of 7 months, with improvement of 66.18% of preoperative ophthalmic abnormalities in patients aged 0-3 months, 69.84% in patients aged 4-6 months, and 43.48% in patients aged 7 months or more. Preoperative astigmatism was found in 89.74% of sagittal patients, 82.61% of coronal patients, 75% of lambdoid patients, and 74.51% of metopic patients. Preoperative strabismus was found in 17.39% coronal patients, 9.80% metopic patients, 7.69% sagittal patients, and no lambdoid patients.
Conclusions :
These results show early intervention for non-syndromic craniosynostosis improves abnormal ophthalmic findings across all observed categories and age groups. Endoscopic craniosynostosis surgery is minimally invasive and improves visual outcomes and quality of life. Future directions include comparison to patients who elected not to get surgery and longitudinal evaluation of the measured ophthalmic parameters compared to controls.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.