Changes in astigmatism after surgery for epiblepharon in highly astigmatic children: a controlled study

To evaluate changes in astigmatism after corrective surgery in highly astigmatic epiblepharon patients compared with nonepiblepharon patients.

We retrospectively reviewed the charts of 37 patients with epiblepharon and 35 patients without epiblepharon, but with initial astigmatism > or =2 D. Demographic data and preoperative data for best-corrected visual acuity, degree of astigmatism, and astigmatism axis were obtained. Postoperative data were collected at 1, 3, 6, and 12 months and at 2 years.

The mean age at surgery was 5.1 +/- 1.5 years. The mean amount of cylinder was 3.27 +/- 0.97 D before surgery and 2.62 +/- 1.07 D at 2 years after surgery. Linear mixed measures analysis, which was used to compare the mean cylinder between the epiblepharon and nonepiblepharon groups, showed significant group-time interaction (p < 0.01). Patients who were younger and had greater initial cylinder showed significantly greater decreases in the cylinder during 2 years of follow-up (p < 0.05).

Significant astigmatic changes were found after surgical correction in epiblepharon patients with 2 D of astigmatism or greater compared with nonepiblepharon patients, and these changes were more significant in patients of younger age and with greater astigmatism. A high prevalence of epiblepharon during the critical period for visual development warrants physician interest in early surgery and visual rehabilitation in highly astigmatic epiblepharon patients.