THE EFFECT OF SEVER EKTROPION ON THE EPITHELIAL CORNEAL MAPPING

We aimed in this study to show the effect of untreated ectropion on ocular surface and corneal epithelium.  

This study was designed as two groups: the first group included 58 eyes of 44 patients with moderate to severe ectropion. The second group included 56 normal individuals with no systemic nor ocular disease. Patients or individuals with contact lens use or previous ocular surgery were excluded from the study. All the measurements were repeated in the ectropion group postoperatively.

Corneal epithelial thickness (CET) measurements of all the patients were performed with an AS-OCT (RTVue-XR, Optovue Inc., USA) in the 6x6 mm of the central cornea. Central (C), Superior (S), superotemporal (ST), temporal (T), inferotemporal (IT), inferior (I), inferonasal (IN), nasal (N) and superonasal (SN) thickness measurement was compared in between groups. The CET measurements were repeated in the ectropion group postoperatively and compared with the preoperative results. 

The mean age was 71±9,9 years in the Ectropion group and 67±6,5 in the control group (p= 0,08) [H1] . Patients were followed up for a mean period of 6 months. There was a statistically significant difference in the CET of the inferotemporal (IT) sectors of cornea between the ectropion and control groups (p = 0,038) [H2] in which the CET was found to be thicker in the ectropion group. Other sectors of the cornea showed no statistically difference in between groups. As we compared the CET in the ectropion group pre and postoperatively the difference in the CET was statistically not significant (p>0,05).

This study revealed that ectropion of the lower eyelid could cause reshaping the corneal epithelium and we believe that this change in the ocular surface could affect the dynamics of the tear film as well as the corneal refraction and visual activity. The improvement in the CET postoperatively could lead us to think that surgical repair of eyelid abnormalities is mandatory to maintain a healthy ocular surface and therefore a good visual acuity. Future studies could take in consideration the keratometry parameters in cases with eyelid abnormalities.