{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:55:54Z","timestamp":1776142554287,"version":"3.50.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 43 pediatric patients (43 eyes) aged 3\u201312\u202fyears 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\u202fmonths postoperatively. Statistical analyses included Spearman correlation, repeated-measures ANOVA, and nonlinear fitting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preoperative entropion severity correlated significantly with cylinder power (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.583) and corneal astigmatism (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.476). Cylinder power decreased progressively from \u22121.34\u202f\u00b1\u202f0.84 D preoperatively to \u22121.04\u202f\u00b1\u202f0.69 D at 6\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Steep corneal curvature (Ks) reduced from 44.41\u202f\u00b1\u202f1.49 D to 43.85\u202f\u00b1\u202f1.45 D at 6\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and further to 43.91\u202f\u00b1\u202f1.28 D at 12\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while corneal astigmatism decreased from 1.82\u202f\u00b1\u202f0.88 D to 1.42\u202f\u00b1\u202f0.68 D at 6\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and remained stable at 1.42\u202f\u00b1\u202f0.74 D at 12\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). No significant change was observed in flat curvature (Kf). Refractive parameters stabilized by 3\u202fmonths postoperatively, with the stabilization point identified at 3.06\u202fmonths. Best corrected visual acuity (BCVA) improved from 0.85\u202f\u00b1\u202f0.19 preoperatively to 0.95\u202f\u00b1\u202f0.09 at 12\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and the proportion of amblyopic eyes decreased from 20.9% (9\/43) preoperatively to 7.0% (3\/43) at 1\u202fyear postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical correction of congenital lower eyelid entropion significantly reduces astigmatism and improves visual acuity in children. Refractive status stabilizes by 3\u202fmonths postoperatively, supporting early intervention to reduce amblyopia risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1822959","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:21:46Z","timestamp":1776140506000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of congenital lower eyelid entropion correction surgery on pediatric astigmatism"],"prefix":"10.3389","volume":"13","author":[{"given":"Jing","family":"Wu","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaxin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Wei","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"763","DOI":"10.3760\/cma.j.issn.0412-4081.2012.08.022","article-title":"Diagnosis and treatment of epiblepharon","volume":"48","author":"Yan","year":"2012","journal-title":"Chin J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/ICU.0000000000000285","article-title":"Management of epiblepharon: state of the art","volume":"27","author":"Woo","year":"2016","journal-title":"Curr Opin Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.ajo.2007.06.022","article-title":"Conjunctival epithelial changes induced by cilia in patients with epiblepharon or entropion","volume":"144","author":"Kim","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1136\/bjophthalmol-2018-312679","article-title":"Epiblepharon outcomes: comparing apples and oranges","volume":"102","author":"Tan","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/j.ajo.2007.01.043","article-title":"Refractive changes in epiblepharon","volume":"143","author":"Preechawai","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s12886-020-01749-7","article-title":"The prevalence of lower eyelid epiblepharon and its association with refractive errors in Chinese preschool children: a cross-sectional study","volume":"21","author":"Zhuo","year":"2021","journal-title":"BMC Ophthalmol"},{"key":"ref7","first-page":"48","article-title":"Astigmatism and meridian amblyopia in children","volume":"24","author":"Zeng","year":"2016","journal-title":"Chin J Strabismus Pediatr Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1136\/bjo.73.2.126","article-title":"Epiblepharon with inverted eyelashes in Japanese children. I. Incidence and symptoms","volume":"73","author":"Noda","year":"1989","journal-title":"Br J Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/5073895","article-title":"Surgical treatment of epiblepharon effectively alleviates keratopathy but not astigmatism: a case-control study utilizing vector analysis in East Asian children","volume":"2020","author":"Ma","year":"2020","journal-title":"J Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12886-025-03940-0","article-title":"The effects of lower eyelid epiblepharon surgery on the Meibomian glands","volume":"25","author":"Kim","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"349","DOI":"10.2147\/opth.S503661","article-title":"Corneal topographic changes due to pediatric epiblepharon surgery","volume":"19","author":"Shindo","year":"2025","journal-title":"Clin Ophthalmol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.19593\/j.issn.2095-0721.2021.11.004","article-title":"Comparative analysis of the effect of different surgical timing on congenital lower eyelid entropion with trichiasis in children","volume":"11","author":"Zheng","year":"2021","journal-title":"China Med Cosmetol"},{"key":"ref13","first-page":"526","article-title":"Effect of surgical timing on intraocular refractive development in children with congenital lower eyelid entropion and trichiasis","volume":"20","author":"Cao","year":"2020","journal-title":"Int Eye Sci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.bjps.2024.05.002","article-title":"Reducing tension step by step in epicanthus and lower eyelid incision for treating cilial entropion in children: a case series analysis","volume":"95","author":"Zhu","year":"2024","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2153","DOI":"10.1007\/s10792-022-02610-0","article-title":"Comparison of the cutaneous orbicularis oculi excision treatment with the inferior eyelid margin fixation treatment for congenital lower eyelid entropion","volume":"43","author":"Huang","year":"2023","journal-title":"Int Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1136\/bjo.84.12.1407","article-title":"Surgical correction for lower lid Epiblepharon in Asians","volume":"84","author":"Woo","year":"2000","journal-title":"Br J Ophthalmol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1097\/sap.0000000000003561","article-title":"Subciliary rotating sutures combined with modified Hotz procedure for correction of congenital lower eyelid entropion","volume":"90","author":"Khuu","year":"2023","journal-title":"Ann Plast Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3341\/kjo.1997.11.2.111","article-title":"Epiblepharon of the lower eyelid: classification and association with astigmatism","volume":"11","author":"Khwarg","year":"1997","journal-title":"Korean J Ophthalmol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/s0886-3350(00)00797-5","article-title":"Power vector analysis of the optical outcome of refractive surgery","volume":"27","author":"Thibos","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"336","DOI":"10.3760\/cma.j.cn112142-20210109-00014","article-title":"Expert consensus on prevention and treatment of amblyopia in Chinese children (2021)","volume":"57","year":"2021","journal-title":"Chin J Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1097\/ICO.0b013e3181451212","article-title":"Astigmatism in children with epiblepharon","volume":"26","author":"Shih","year":"2007","journal-title":"Cornea"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"103938","DOI":"10.1016\/j.jaapos.2024.103938","article-title":"Congenital epiblepharon in Chinese school-age children: a cross-sectional study","volume":"28","author":"Huang","year":"2024","journal-title":"J AAPOS"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1097\/01.ico.0000130418.73493.d0","article-title":"Reverse ptosis-induced corneal steepening and decreased vision after Lasik surgery","volume":"23","author":"Ben Simon","year":"2004","journal-title":"Cornea"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3341\/kjo.2001.15.1.32","article-title":"Refractive changes of congenital entropion and epiblepharon on surgical correction","volume":"15","author":"Yang","year":"2001","journal-title":"Korean J Ophthalmol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/0039-6257(84)90094-8","article-title":"Keratoconus and related noninflammatory corneal thinning disorders","volume":"28","author":"Krachmer","year":"1984","journal-title":"Surv Ophthalmol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1006\/exer.1996.0038","article-title":"Epithelial injury induces keratocyte apoptosis: hypothesized role for the interleukin-1 system in the modulation of corneal tissue organization and wound healing","volume":"62","author":"Wilson","year":"1996","journal-title":"Exp Eye Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e459","DOI":"10.1097\/scs.0000000000006448","article-title":"Relationship between visual acuity and corneal curvature change in children after epiblepharon surgery","volume":"31","author":"Suh","year":"2020","journal-title":"J Craniofac Surg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"102","DOI":"10.3109\/09286586.2013.767355","article-title":"Developmental changes in anterior corneal astigmatism in Tohono O'odham native American infants and children","volume":"20","author":"Harvey","year":"2013","journal-title":"Ophthalmic Epidemiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"100606","DOI":"10.1016\/j.optom.2025.100606","article-title":"Long-term astigmatism progression and its interaction with spherical equivalent in Chinese school-age children: a hospital-based cohort study","volume":"19","author":"Qin","year":"2026","journal-title":"J Optom"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3928\/01913913-20080101-18","article-title":"The effect of surgical correction of epiblepharon on astigmatism in children","volume":"45","author":"Park","year":"2008","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.jaapos.2008.06.010","article-title":"Changes in astigmatism after surgery for epiblepharon in highly astigmatic children: a controlled study","volume":"12","author":"Kim","year":"2008","journal-title":"J AAPOS"},{"key":"ref32","first-page":"223","article-title":"Change of visual acuity and astigmatism after operation in epiblepharon children","volume":"42","author":"Lee","year":"2001","journal-title":"J Korean Ophthalmol Soc"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"257","DOI":"10.3928\/01913913-20240118-02","article-title":"Sensory function of children with strabismus after Epiblepharon surgery","volume":"61","author":"You","year":"2024","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"178","DOI":"10.3760\/cma.j.issn.0412-4081.2015.03.006","article-title":"Observation of refractive status and corneal morphology after discontinuation of orthokeratology lenses","volume":"51","author":"Yang","year":"2015","journal-title":"Chin J Ophthalmol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1822959\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:21:49Z","timestamp":1776140509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1822959\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":34,"alternative-id":["10.3389\/fmed.2026.1822959"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1822959","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"article-number":"1822959"}}