Surgical Treatment of Epiblepharon Effectively Alleviates Keratopathy but Not Astigmatism: A Case-Control Study Utilizing Vector Analysis in East Asian Children

Surgical management of patients with corneal lesions due to lid pathologies

BACKGROUND

The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes. Eyelid lesions, ranging from benign to malignant, can lead to corneal damage through mechanisms such as mechanical abrasion, secondary infection, or inflammatory responses.

AIM

To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes, recurrence rates, and postoperative complications. The incorporation of advanced imaging techniques, including optical coherence tomography and ultrasound biomicroscopy, in conjunction with histopathological analysis, is addressed to improve surgical accuracy and patient outcomes.

METHODS

The authors searched online databases (PubMed and Cochrane) for publications on the surgical management of lid lesions. Records received from the two databases were checked for duplicates and relevance. Only records with full texts and in English language were included.

RESULTS

A total of 28 records were obtained following the screening for relevancy and duplication. The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases, focusing on operative efficacy, complication rates, and long-term results.

CONCLUSION

This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care. The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.

Sensory Function of Children With Strabismus After Epiblepharon Surgery

PURPOSE

To investigate the effect of epiblepharon surgery on motor and sensory function in children with epiblepharon and concomitant strabismus.

METHODS

Among 564 patients who underwent epiblepharon correction surgery from May 2016 to April 2023, 45 children who were examined for strabismus were included in the study. Preoperative and postoperative visual acuity, refraction, and angle of deviation were analyzed. For those with significant angle of deviation, additional stereopsis, sensory fusion, and returning time were retrospectively investigated. The angle of deviation was examined by one examiner at distance and near.

RESULTS

The mean age of 45 children (18 boys and 27 girls) was 6.8 ± 2.9 years. Fifteen had significant strabismus at the time of epiblepharon surgery. Visual acuity improved in both the total and strabismus groups. Improvement in stereopsis and fusion was also observed in the strabismus group. The angle of deviation showed no difference in both groups.

CONCLUSIONS

Epiblepharon could affect ocular manifestations of strabismus as shown in this study. The authors suggest strabismus treatment be continued after epiblepharon surgery, with improved sensory function. Further evaluation with larger groups is needed in the future. [J Pediatr Ophthalmol Strabismus. 2024;61(4):257-261.].

Severe corneal involvement secondary to congenital lower eyelid epiblepharon

PURPOSE

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

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.