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The authors aimed to analyse the corneal morphology before and after advancement of posterior lower eyelid retractors (LERs) alone or in combination with a lateral tarsal strip (LTS) for lower eyelid involutional entropion. Retrospective analysis of 24 consecutive elderly patients (24 eyelids) who underwent posterior layer advancement of LERs alone or in combination with an LTS for involutional entropion was performed. All patients underwent best-corrected visual acuity (BCVA) assessment, fundus examination, and slit-lamp microscopy. The degree of corneal damage was evaluated using the area (A) and density (D) classification of corneal fluorescein staining. Corneal topography was measured using anterior segment optical coherence tomography (AS-OCT). The parameters were steep keratometry (Ks), flat keratometry (Kf), average keratometry (AveK), cylindrical power (CYL), central corneal thickness (CCT), and total higher-order aberrations (HOAs) within a 4mm diameter. There was no significant difference in the Ks, Kf, AveK, CYL or CCT values pre or postoperatively. HOAs were significantly reduced following surgery. In the AD classification, both the A and D values were significantly decreased after surgery. Significant correlations were observed between preoperative mean HOAs and the mean of A classification, and between preoperative mean HOAs and the mean of D classification. In summary, involutional entropion did not significantly affect corneal morphology before or after posterior LER advancement alone or in combination with an LTS. However, this surgery is thought to result in an improvement of corneal disorders and consequently HOAs.

Corneal topographic analysis in patients with involutional lower eyelid entropion.
Yunoki T, Hayashi A, Abe S, Otsuka M.
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Su Young

Moorfields Eye Hospital NHS Trust, London, UK.

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