Park Young Min, Lee Jong Soo
Department of Ophthalmology, School of Medicine, Pusan National University & Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
Cont Lens Anterior Eye. 2014 Oct;37(5):342-5. doi: 10.1016/j.clae.2014.05.002. Epub 2014 Jun 2.
This study is the first to consider the effects of chalazion on corneal surface aberrations taking into account of corneal zones, and to establish the size standard for the excision of chalazion.
Twenty three eyes from 23 patients with central upper eyelid chalazion larger than 3mm were recruited in this prospective study. The participants were classified into two groups, depending on size of the lesion: Group 1 with lesion size 3-5mm and Group 2 with lesion size >5mm Chalazion was excised by standard transconjunctival vertical incision. Corneal surface aberrations were measured using a Galilei™ analyzer and an auto-refractometer before and 2 months after the excision.
Corneal astigmatism in all patients decreased significantly in both auto refractometer (P=0.012) and Galilei™ (P=0.020) measurements after chalazion excision. RMS of total HOAs decreased significantly in 6mm (P=0.043) and 3mm zone (P=0.051). The RMS of Zernike orders in the vertical and horizontal trefoil decreased significantly in 6mm (P=0.035) and 3mm (P=0.041) zone. Group 2 showed a significant decrease in corneal astigmatism in both auto refractometer (P=0.040) and Galilei™ (P=0.017) parameters after chalazion excision. Group 1 showed an insignificant decrease in corneal astigmatism. Unlike Group 1, the RMS of total HOAs and vertical and horizontal trefoil in 6mm zone decreased significantly in Group 2 (P<0.05).
The existence of an upper lid chalazion increases astigmatism and HOAs, especially at the peripheral cornea. Significantly induced astigmatism and HOAs are caused by chalazion >5mm in size. Thus, we recommend the surgical excision of chalazion >5mm in size to reduce corneal surface aberrations.
本研究首次考虑睑板腺囊肿对角膜表面像差的影响,并将角膜区域纳入考量,同时建立睑板腺囊肿切除的大小标准。
本前瞻性研究纳入了23例中央上睑睑板腺囊肿大于3mm的患者的23只眼。根据病变大小将参与者分为两组:第1组病变大小为3 - 5mm,第2组病变大小>5mm。通过标准的经结膜垂直切口切除睑板腺囊肿。在切除术前和术后2个月使用Galilei™分析仪和自动验光仪测量角膜表面像差。
睑板腺囊肿切除术后,所有患者的角膜散光在自动验光仪测量(P = 0.012)和Galilei™测量(P = 0.020)中均显著降低。总高阶像差的均方根在6mm区域(P = 0.043)和3mm区域(P = 0.051)显著降低。6mm区域(P = 0.035)和3mm区域(P = 0.041)的垂直和水平三叶像差的泽尼克系数均方根显著降低。第2组在睑板腺囊肿切除术后,自动验光仪(P = 0.040)和Galilei™(P = 0.017)参数中的角膜散光均显著降低。第1组角膜散光降低不显著。与第1组不同,第2组6mm区域的总高阶像差以及垂直和水平三叶像差的均方根显著降低(P < 0.05)。
上睑睑板腺囊肿的存在会增加散光和高阶像差,尤其是在周边角膜。大小>5mm的睑板腺囊肿会显著诱发散光和高阶像差。因此,我们建议手术切除大小>5mm的睑板腺囊肿以减少角膜表面像差。