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Updated: Jul 11, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Astigmatism in children with epiblepharon
1Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan.
Insights
Children needing surgery for epiblepharon (eyelid turning inward) have increased astigmatism, particularly in the 4-7 year age group. Severe corneal erosion correlates with higher astigmatism, which surgery does not significantly correct.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Diseases
Background:
- Epiblepharon, an inward turning of the eyelid, can cause corneal irritation and visual disturbances in children.
- Astigmatism, a refractive error, is common in pediatric populations and can impact visual development.
Purpose of the Study:
- To investigate the association between astigmatism and epiblepharon requiring surgical intervention in Taiwanese children.
- To compare astigmatism severity in children with epiblepharon versus a control group.
Main Methods:
- A retrospective case-control study analyzed 254 eyes of children with surgically treated lower-lid epiblepharon and 205 control eyes.
- Data included age, sex, corneal erosion severity, visual acuity, and refractive errors (astigmatism decomposed into P90 and Pobl).
- Nonparametric tests were used to compare astigmatism severity between groups.
Main Results:
- Children aged 4-7 with epiblepharon showed significantly higher P90 astigmatism (1.12 D) compared to controls (0.47 D).
- More severe corneal erosion was significantly associated with greater astigmatism (P = 0.002), even after healing.
- Postoperative astigmatism (P90 and Pobl) did not show significant changes after surgical correction.
Conclusions:
- Pediatric epiblepharon requiring surgery is linked to increased with-the-rule astigmatism compared to controls.
- The degree of corneal erosion severity is a predictor of higher astigmatism in these children.
- Surgical correction of epiblepharon and subsequent reepithelialization did not significantly reduce astigmatism.
Purpose:
To study the relationship between astigmatism and epiblepharon in Taiwanese children that need surgical correction.
Methods:
In a retrospective case-control study, a total of 254 eyes in 134 children surgically treated for lower-lid epiblepharon were studied. A further 205 eyes in 104 children 4-7 years of age were included as controls. Data on age, sex, severity of preoperative corneal erosion, best-corrected visual acuity, and preoperative and postoperative refractive errors were recorded. The data of astigmatism were decomposed into P90 (at 90 degrees) and its oblique meridian Pobl. Nonparametric tests were used to compare the severity of astigmatism.
Results:
No significant difference between age group (<4, 4-7, >7 years) in P90 was shown in children with epiblepharon. Pobl was trivial in each group of epiblepharon. Children with epiblepharon 4-7 years of age had significantly (P < 0.001) greater P90 than controls (1.12 vs. 0.47 D). P90 and Pobl were not significantly changed postoperatively. In the same individual, the eye with the more severely affected cornea had greater astigmatism (P = 0.002), even after the corneal erosion healed.
Conclusions:
Children with epiblepharon who needed surgery had greater with-the-rule astigmatism than controls. More severe corneal erosion was associated with higher astigmatism. Surgical correction of skinfold and promotion of reepithelialization did not attenuate astigmatism significantly.
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