Effects of epiblepharon surgery on higher-order aberrations

To quantify and compare higher-order aberrations (HOAs) in children after epiblepharon surgery.

The medical records of children (mean age, 7.3 years [range, 2-13 years]) who underwent surgery for epiblepharon were reviewed retrospectively. Aberrometry was conducted before surgery and at 1 month's and 3 months' follow-up using the Wavefront Analyzer KR-1W. Corneal HOAs in the 4 mm and 6 mm optical zones were compared. Classification of the severity of epiblepharon was based on the degree of cilia touching the cornea and corneal erosion.

A total of 120 eyes of 60 patients were included. Corneal total HOAs in the 4 mm and 6 mm optical zone decreased significantly at 1 and 3 months after surgery (P = 0.001 and 0.000, resp.. in the 4 mm zone; P = 0.006 and 0.006 in the 6 mm zone). Surgery induced a significant reduction of fourth-order aberrations, with decrease of tetrafoil in the 4 mm zone and coma, tetrafoil, and secondary astigmatism in the 6 mm zone 3 months after surgery; the differences were statistically significant (P = 0.038 and 0.006 in the 4 mm zone; P = 0.018 and 0.000 in the 6 mm zone). Although there was no significant association between epiblepharon severity and total HOAs, reduction of corneal staining grade and decrease of total HOAs at 3 months were significantly correlated (P = 0.03 in the 6 mm zone).

In this patient cohort, total HOAs decreased significantly after epiblepharon surgery. The correlation of reduction of corneal staining grade and decrease of total HOAs may be helpful in deciding the timing of surgery in children who have no specific visual symptoms.