Severe corneal involvement secondary to congenital lower eyelid epiblepharon

The study aims to examine an incidence and risk factors of severe corneal involvement in patients with congenital lower eyelid epiblepharon.

This retrospective, observational study included 509 patients (933 eyes) with congenital lower eyelid epiblepharon. Data on age, sex, affected side, past history, past surgery, presence or absence of concomitant periocular/ocular diseases, body height and weight, astigmatic power, and corneal involvement were collected. Severe corneal involvement included corneal scarring, vascularization, and perforation.

Severe corneal involvement was found in 30 patients (5.9%) (34 eyes, 3.6%). Corneal scarring and perforation with scarring were shown in 29 patients (33 eyes) and 1 patient (1 eye), respectively. Nine patients (12 eyes) demonstrated concomitant corneal vascularization with corneal scarring. Logistic regression analysis showed that body mass index had an odds ratio of 1.057 (P = 0.078). Age and sex did not affect occurrence of severe corneal involvement (P > 0.050).

In this study, 5.9% of patients showed severe corneal involvement in congenital lower eyelid epiblepharon. Logistic regression analysis indicates that a high body mass index was a possible risk factor of severe corneal involvement caused by congenital lower eyelid epiblepharon.