Korean J Ophthalmol.  2010 Dec;24(6):325-330. 10.3341/kjo.2010.24.6.325.

The Effect of Epiblepharon Surgery on Visual Acuity and With-the-Rule Astigmatism in Children

• Kim NM
• Jung JH
• Choi HY

• KMID: 1769084
• DOI: http://doi.org/10.3341/kjo.2010.24.6.325

Abstract

PURPOSE
To evaluate the effect of epiblepharon surgery on visual acuity and with-the-rule astigmatism in children compared to patients without surgical treatment.
METHODS
We undertook a retrospective case control study and reviewed the charts of 202 eyes treated with epiblepharon surgery and of 142 eyes without surgery. The surgical procedure for epiblepharon correction used rotating suture techniques. Data regarding age, best corrected visual acuity, and degree of astigmatism were recorded. Baseline and 1-, 3-, 6-, and 12-month postoperative data were collected. The chi-square test, Student's t-test and general linear model analysis for repeated measures were applied.
RESULTS
The mean astigmatism in the surgical group decreased from 1.10 +/- 1.02 diopter (D) preoperatively to 0.84 +/- 1.05 D at 3 months after surgery (p < 0.05). However, there was no statistically significant difference compared to the non-surgical group during the first year. The general linear model analysis comparing the mean astigmatism between the two groups over time showed a significant group-time interaction (p < 0.05). Within the surgical group, the higher baseline astigmatic subgroup and the 5- to 8-year-old group demonstrated greater cylinder reduction over time. The change in mean visual acuity was not significant in either group.
CONCLUSIONS
Significant astigmatic reduction was found after surgical correction in epiblepharon patients. Patients with higher baseline astigmatism exhibited greater astigmatic reduction after epiblepharon surgery. These results suggest that, in order to reduce astigmatism, an epiblepharon operation should be considered in patients with a high level of astigmatism.

Keyword

Astigmatism; Epiblepharon; Visual acuity

MeSH Terms

Astigmatism/*etiology/*physiopathology
Case-Control Studies
Child
Child, Preschool
Eye Abnormalities/*complications/*surgery
Eyelashes/pathology
Eyelids/*abnormalities/pathology/surgery
Female
Humans
Male
Retrospective Studies
Treatment Outcome
*Visual Acuity

Figure

• 

  Fig. 1 Mean astigmatism for each age subgroup in the surgical and non-surgical groups. There was a statistically significant decrease in astigmatism in subgroup 2 at 3 months postoperative (from 1.25± 1.02 diopter [D] to 0.89±0.96 D with-the-rule astigmatism, p = 0.049). *p<0.05; †Subgroup 1, younger than 5 years; subgroup 2, 5 to 8 years; subgroup 3, 8 years and older.

• 

  Fig. 2 Mean cylinder changes in subgroup A, B, and C over 1 year. Within the surgical group, the higher baseline astigmatic subgroup demonstrated greater cylinder reduction over time compared to the lower astigmatic subgroup at 1 year postoperative. *p<0.05; †Subgroup A, < 2 diopter (D); subgroup B, 2 to < 4 D; subgroup C, ≥ 4 D.

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