Morphological changes after lower eyelid epiblepharon surgery in Asian children

Background: This study aimed to determine the morphological changes in Asian lower eyelid epiblepharon patients after surgery. Methods: The medical records of 59 patients who underwent lower eyelid epiblepharon repair were reviewed retrospectively. Eighty-nine patients who underwent strabismus surgery were set as the control group. The photographs for each group were analyzed based on the following factors: inferior half area (IHA) of the eye, eyelash angular direction (EAD), angle between the eyelashes and the cornea, marginal reflex distance 1 (MRD₁) and marginal reflex distance 2 (MRD₂). Results: After surgery, the medial EAD changed from 92.45° ± 20.21° (mean ± SD) to 79.43° ± 23.31°, while the central and lateral EADs were unchanged. IHA increased from 36.33 ± 9.78 mm³ to 43.06 ± 10.57 mm³, and MRD₁ increased from 1.92 ± 0.99 mm to 2.50 ± 0.93 mm, whereas MRD₂ did not change. The mean angle between the eyelashes and the cornea increased from 39.64° to 72.19° immediately postoperatively, but had reduced to 58.75° 3 months later, followed by no further significant change at the 6-month and 9-month postoperative follow-ups. Conclusions: There is morphological changes of the eyelid after lower eyelid epiblepharon surgery, with increases in the IHA and MRD_1. In addition, contact between the eyelashes and the cornea occurred mainly in the medial portion of the eyelid the position, which everted and stabilized over 3 months. Thus, follow-up observations are required for at least 3 months to properly evaluate the surgical outcome.