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Impact of congenital lower eyelid entropion correction surgery on pediatric astigmatism
Jing Wu1, Yaxin Zhao1, Nan Wei1
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Insights
Congenital lower eyelid entropion surgery significantly reduces astigmatism and improves vision in children. Early intervention is key, as refractive status stabilizes around 3 months post-surgery, lowering amblyopia risk.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Refractive Error Correction
Background:
- Congenital lower eyelid entropion can lead to significant visual impairment in children.
- Understanding the impact of surgical correction on refractive status and corneal astigmatism is crucial for timely intervention.
Purpose of the Study:
- To evaluate the effect of congenital lower eyelid entropion surgery on refractive status and corneal astigmatism in pediatric patients.
- To explore optimal surgical timing and visual rehabilitation strategies.
Main Methods:
- A cohort of 43 pediatric patients (3-12 years) underwent entropion correction.
- Preoperative and postoperative assessments included best-corrected visual acuity (BCVA), cycloplegic refraction, and corneal topography at multiple time points up to 12 months.
- Statistical analyses employed Spearman correlation, repeated-measures ANOVA, and nonlinear fitting.
Main Results:
- Preoperative entropion severity correlated with cylinder power and corneal astigmatism.
- Significant reductions in cylinder power, steep corneal curvature (Ks), and corneal astigmatism were observed post-surgery, stabilizing by 3 months.
- Best-corrected visual acuity (BCVA) improved, and the incidence of amblyopic eyes decreased significantly within one year.
Conclusions:
- Surgical correction of congenital lower eyelid entropion effectively reduces astigmatism and enhances visual acuity in children.
- Refractive stabilization occurs by 3 months post-operation, underscoring the benefit of early surgical intervention to mitigate amblyopia.
Objective:
To evaluate the effect of congenital lower eyelid entropion surgery on refractive status and corneal astigmatism in children, and to explore surgical timing and visual rehabilitation.
Methods:
A total of 43 pediatric patients (43 eyes) aged 3-12 years who underwent entropion correction between June 2022 and June 2023 were included. Best-corrected visual acuity (BCVA), cycloplegic refraction and corneal topography were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Statistical analyses included Spearman correlation, repeated-measures ANOVA, and nonlinear fitting.
Results:
Preoperative entropion severity correlated significantly with cylinder power (r = -0.583) and corneal astigmatism (r = 0.476). Cylinder power decreased progressively from -1.34 ± 0.84 D preoperatively to -1.04 ± 0.69 D at 6 months (p < 0.001). Steep corneal curvature (Ks) reduced from 44.41 ± 1.49 D to 43.85 ± 1.45 D at 6 months (p < 0.001), and further to 43.91 ± 1.28 D at 12 months (p < 0.001), while corneal astigmatism decreased from 1.82 ± 0.88 D to 1.42 ± 0.68 D at 6 months (p < 0.001) and remained stable at 1.42 ± 0.74 D at 12 months (p < 0.05). No significant change was observed in flat curvature (Kf). Refractive parameters stabilized by 3 months postoperatively, with the stabilization point identified at 3.06 months. Best corrected visual acuity (BCVA) improved from 0.85 ± 0.19 preoperatively to 0.95 ± 0.09 at 12 months (p < 0.001), and the proportion of amblyopic eyes decreased from 20.9% (9/43) preoperatively to 7.0% (3/43) at 1 year postoperatively.
Conclusion:
Surgical correction of congenital lower eyelid entropion significantly reduces astigmatism and improves visual acuity in children. Refractive status stabilizes by 3 months postoperatively, supporting early intervention to reduce amblyopia risk.
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