Astigmatism in children with epiblepharon

PURPOSE: To study the relationship between astigmatism and epiblepharon in Taiwanese children that need surgical correction. METHODS: In a retrospective case-control study, a total of 254 eyes in 134 children surgically treated for lower-lid epiblepharon were studied. A further 205 eyes in 104 children 4-7 years of age were included as controls. Data on age, sex, severity of preoperative corneal erosion, best-corrected visual acuity, and preoperative and postoperative refractive errors were recorded. The data of astigmatism were decomposed into P90 (at 90 degrees) and its oblique meridian Pobl. Nonparametric tests were used to compare the severity of astigmatism. RESULTS: No significant difference between age group (<4, 4-7, >7 years) in P90 was shown in children with epiblepharon. Pobl was trivial in each group of epiblepharon. Children with epiblepharon 4-7 years of age had significantly (P < 0.001) greater P90 than controls (1.12 vs. 0.47 D). P90 and Pobl were not significantly changed postoperatively. In the same individual, the eye with the more severely affected cornea had greater astigmatism (P = 0.002), even after the corneal erosion healed. CONCLUSIONS: Children with epiblepharon who needed surgery had greater with-the-rule astigmatism than controls. More severe corneal erosion was associated with higher astigmatism. Surgical correction of skinfold and promotion of reepithelialization did not attenuate astigmatism significantly.