Bagheri Abbas, Hasani Hamid R, Karimian Farid, Abrishami Mohammad, Yazdani Shahin
Department of Ophthalmology, Labbafinejad Hospital, Shaheed Beheshti Medical University, Ophthalmic Research Center, Tehran - Iran.
Eur J Ophthalmol. 2009 Jul-Aug;19(4):521-6. doi: 10.1177/112067210901900401.
To evaluate refractive and corneal topographic changes following excision of chalazia.
This prospective noncomparative quasi-experimental clinical trial includes consecutive patients older than 7 years with chalazia of minimum duration of 1 month who underwent excision of the lesions by an internal or external approach.
Overall, 253 lids from 228 eyes of 195 patients including 110 female subjects with mean age of 31-/+14 years (range 7-71) were studied. Mean duration of presenting symptoms was 4-/+2.8 months (range 1-24). Lesions were equally distributed in medial, central, and lateral areas of the eyelids. The chalazia were single in 172 (88.2%) and multiple in 23 (11.8%) patients. Mean change in best-corrected visual acuity, spherical equivalent refractive error, and difference of keratometry (corneal astigmatism) were 0.0004-/+0.007 logMAR (p=0.3), -0.06-/+0.6 D (p=0.1), and 0.34-/+0.35 (p<0.0001) after surgery, respectively. Corneal topographic analysis revealed significant changes in surface regularity index (0.13), surface asymmetry index (0.09), and potential visual acuity (0.06-/+0.1 logMAR) after the procedure (p<0.0001 for all comparisons). Single, central, and firm chalazia were compared with multiple, peripheral, and soft lesions; change in difference of keratometry and spherical equivalent were 0.75-/+0.42 D versus 0.22-/+0.15 D (p=0.001) and -0.35-/+0.19 versus -0.11-/+0.30 D (p=0.1), respectively, implying more induced astigmatism with the former type of lesions.
Chalazion excision can decrease corneal astigmatism and irregularity, which is more prominent in single, firm, and central upper lid lesions. These findings may have implications in pediatric patients at risk for amblyopia.
评估睑板腺囊肿切除术后的屈光和角膜地形图变化。
这项前瞻性非对照半实验性临床试验纳入了年龄大于7岁、睑板腺囊肿持续时间至少1个月的连续患者，这些患者通过内路或外路进行了病变切除。
总体上，研究了195例患者228只眼中的253个眼睑，其中包括110名女性受试者，平均年龄为31±14岁（范围7 - 71岁）。出现症状的平均持续时间为4±2.8个月（范围1 - 24个月）。病变在眼睑的内侧、中央和外侧区域分布均匀。172例（88.2%）患者的睑板腺囊肿为单个，23例（11.8%）患者为多个。术后最佳矫正视力、等效球镜屈光不正和角膜曲率计差值（角膜散光）的平均变化分别为0.0004±0.007 logMAR（p = 0.3）、-0.06±0.6 D（p = 0.1）和0.34±0.35（p < 0.0001）。角膜地形图分析显示，术后表面规则性指数（0.13）、表面不对称指数（0.09）和潜在视力（0.06±0.1 logMAR）有显著变化（所有比较p < 0.0001）。将单个、中央和坚实的睑板腺囊肿与多个、周边和柔软的病变进行比较；角膜曲率计差值和等效球镜的变化分别为0.75±0.42 D对0.22±0.15 D（p = 0.001）和-0.35±0.19对-0.11±0.30 D（p = 0.1），这意味着前一种类型的病变诱导的散光更多。
睑板腺囊肿切除术可降低角膜散光和不规则度，在单个、坚实和中央上睑病变中更为明显。这些发现可能对有弱视风险的儿科患者有影响。
