Analysis of corneal real astigmatism changes and high order aberration after lower eyelid epiblepharon repair surgery

Abstract

Objective: To investigate changes in corneal low and high order aberrations (LOA and HOA), which cause visual disturbances after lower eyelid epiblepharon repair surgery. Methods and analysis: This was a retrospective, cross-sectional study, which included 108 eyes from 54 patients. Wavefront analyses for calibrated LOAs and HOAs (root mean square, coma, three-piece aberrations [Trefoil], secondary astigmatisms, and spherical aberrations [SA]) were performed via a Galilei G4 Dual Scheimpflug Analyzer preoperatively, at the first and second follow-ups (f/u), and at G1, G2, and G3 (<45 days, 45-75 days, and >75 days post-surgery). Several risk factors (age, sex, body mass index, and corneal keratitis presence) were assessed. Results: In LOAs, flat keratometer (K) and axis values decreased significantly from baseline at the first f/u. At the second f/u, mean K and axis decreased. In HOAs, coma and trefoil increased from baseline at the first f/u and normalized by the second f/u. SA decreased at the second f/u and in G3. The various risk factors did not affect postoperative outcomes, axis, and secondary astigmatisms. After correcting for risk factors, at the first f/u, cylinder, coma, trefoil, and SA increased significantly from the baseline, while axis and flat K decreased. At the second f/u, cylinder increased, while axis and mean K decreased significantly from the baseline. Conclusion: Epiblepharon repair surgery may impact axis changes. Flat K, coma, and trefoil may be affected by mechanical force changes immediately following surgery. Mean K and SA may change with cornea state changes during healing.