Abstract
OBJECTIVE: To evaluate the effect of congenital lower eyelid entropion surgery on refractive status and corneal astigmatism in children, and to explore surgical timing and visual rehabilitation. METHODS: A total of 43 pediatric patients (43 eyes) aged 3-12 years who underwent entropion correction between June 2022 and June 2023 were included. Best-corrected visual acuity (BCVA), cycloplegic refraction and corneal topography were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Statistical analyses included Spearman correlation, repeated-measures ANOVA, and nonlinear fitting. RESULTS: Preoperative entropion severity correlated significantly with cylinder power (r = -0.583) and corneal astigmatism (r = 0.476). Cylinder power decreased progressively from -1.34 ± 0.84 D preoperatively to -1.04 ± 0.69 D at 6 months (p < 0.001). Steep corneal curvature (Ks) reduced from 44.41 ± 1.49 D to 43.85 ± 1.45 D at 6 months (p < 0.001), and further to 43.91 ± 1.28 D at 12 months (p < 0.001), while corneal astigmatism decreased from 1.82 ± 0.88 D to 1.42 ± 0.68 D at 6 months (p < 0.001) and remained stable at 1.42 ± 0.74 D at 12 months (p < 0.05). No significant change was observed in flat curvature (Kf). Refractive parameters stabilized by 3 months postoperatively, with the stabilization point identified at 3.06 months. Best corrected visual acuity (BCVA) improved from 0.85 ± 0.19 preoperatively to 0.95 ± 0.09 at 12 months (p < 0.001), and the proportion of amblyopic eyes decreased from 20.9% (9/43) preoperatively to 7.0% (3/43) at 1 year postoperatively. CONCLUSION: Surgical correction of congenital lower eyelid entropion significantly reduces astigmatism and improves visual acuity in children. Refractive status stabilizes by 3 months postoperatively, supporting early intervention to reduce amblyopia risk.