Impact of congenital lower eyelid entropion correction surgery on pediatric astigmatism.

OBJECTIVE

To evaluate the effect of congenital lower eyelid entropion surgery on refractive status and corneal astigmatism in children, and to explore surgical timing and visual rehabilitation.

METHODS

A total of 43 pediatric patients (43 eyes) aged 3-12 years who underwent entropion correction between June 2022 and June 2023 were included. Best-corrected visual acuity (BCVA), cycloplegic refraction and corneal topography were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Statistical analyses included Spearman correlation, repeated-measures ANOVA, and nonlinear fitting.

RESULTS

Preoperative entropion severity correlated significantly with cylinder power (r = -0.583) and corneal astigmatism (r = 0.476). Cylinder power decreased progressively from -1.34 ± 0.84 D preoperatively to -1.04 ± 0.69 D at 6 months (p < 0.001). Steep corneal curvature (Ks) reduced from 44.41 ± 1.49 D to 43.85 ± 1.45 D at 6 months (p < 0.001), and further to 43.91 ± 1.28 D at 12 months (p < 0.001), while corneal astigmatism decreased from 1.82 ± 0.88 D to 1.42 ± 0.68 D at 6 months (p < 0.001) and remained stable at 1.42 ± 0.74 D at 12 months (p < 0.05). No significant change was observed in flat curvature (Kf). Refractive parameters stabilized by 3 months postoperatively, with the stabilization point identified at 3.06 months. Best corrected visual acuity (BCVA) improved from 0.85 ± 0.19 preoperatively to 0.95 ± 0.09 at 12 months (p < 0.001), and the proportion of amblyopic eyes decreased from 20.9% (9/43) preoperatively to 7.0% (3/43) at 1 year postoperatively.

CONCLUSION

Surgical correction of congenital lower eyelid entropion significantly reduces astigmatism and improves visual acuity in children. Refractive status stabilizes by 3 months postoperatively, supporting early intervention to reduce amblyopia risk.