Effect of Chalazion Excision on Refractive Error and Corneal Topography

Abstract

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.