Purpose: This study was conducted to investigate changes in corneal shape and higher-order aberrations before and after surgery for congenital cilial entropion.
Subjects and methods: From January 2018 to January 2020, 78 eyes from 45 patients, comprising 21 males and 24 females (3-18 years, mean age 7.8±6.4 years) underwent primary surgery with modified Hotz method for congenital cilial entropion by the same surgeon (X.Z.) at Ehime University Hospital and Hanamizuki Eye Clinic and were included in this study. Refractive index, visual acuity, intraocular pressure, anteroposterior astigmatism of the cornea analyzed using anterior segment optical coherence tomography (OCT) (CASIA2, Tomey), eccentricity of the cornea (ECC), and corneal higher-order aberrations assessed using OPD-Scan^ⓇIII (Nidek) were analyzed before and at 1 and 3 months after surgery.
Results: No significant differences were noted in refractive index, corrected visual acuity, and intraocular pressure between before and at each time point after surgery. However, the uncorrected visual acuity at 3 months after surgery was -0.02±0.09 logMAR, which was significantly better than the preoperative visual acuity of 0.05±0.19 logMAR (p=0.022, Dunnett test). Corneal astigmatism was 1.54±0.79 D, 1.32±0.64 D, and 1.16±0.62 D preoperatively and at 1 and 3 months postoperatively, respectively, showing a significant reduction in astigmatism at 3 months after surgery compared with before surgery (p=0.034). The ECC at 3 months after surgery was 0.53±0.11, which was significantly reduced from 0.61±0.13 before surgery (p=0.024). Corneal higher-order aberrations were 1.02±0.98 μm preoperatively, 0.75±0.36 μm at 1 month after surgery, and 0.53±0.34 μm at 3 months after surgery, indicating significant reductions after surgery compared with before surgery (p=0.025, p=0.007).
Conclusion: Corneal shape and higher-order aberrations significantly improved after surgery for congenital cilial entropion compared with before surgery, suggesting possible improvements in visual function.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 539-544, 2021.