Effect of Eyelid Surgery on Corneal Topography
Narrative Responses:
Purpose
To determine the effect of upper and lower eyelid surgeries on corneal steepness, astigmatism, and corneal aberrations in order to allow for improved informed consent and spectacle correction after surgery.
Methods
IRB approved prospective, nonrandomized, observational study from July 2012-March 2013. Inclusion criteria: AD military or DoD beneficiaries ≥18yrs who underwent eyelid surgeries including entropion, ectropion, or ptosis repair, blepharoplasty, and gold weight implantation. Bilateral corneal topography using the Pentacam® (Oculus) was performed prior to surgery and at weeks 1, 6-8, and 6 months after surgery. Primary outcome measures included true net power, K1, K2, astigmatism, axis, total corneal aberrations, and higher order aberrations (HOAs). Secondary outcome measures included pupil size and total lower order aberrations (LOAs). Statistical analysis performed using a paired t-test.
Results
46 eyes, mean age 60, 17 female, 7 male, 22 procedures. Analysis showed less than 1 Diopter (D) astigmatism change after surgery. Paired t-test showed no statistical significance in astigmatism change before and after surgery at post-op week (POW) 1. Minority had astigmatism change of ≥ 1D at POW 1, but less than 1 D change at POW 6-8. Overall, 13% changed from with-the-rule (WTR) to oblique, 13% from oblique to WTR at POW 1. No significant difference at POW 1, 6-8 in total corneal and higher order aberrations. No significant difference in other outcome measures at POW 1, 6-8.
Conclusion
No statistically significant change in corneal astigmatism using Pentacam® analysis at POW 1, 6-8. No significant change in corneal or higher order aberrations at either time point. Study limitation is small sample size; larger sample size may clarify change in astigmatism seen in some patients.