Effects of Chalazion on Refractive Error and Corneal Topography

To evaluate the effect of location and size of chalazia on refractive error, corneal topography and visual acuity. This randomized non-controlled clinical trial was conducted on patients with chalazion aged more than 3 years with minimum duration of one month. All patients underwent chalazion excision by the internal or external approach. Two-hundred and fifty-three eyelids of 228 eyes of 195 patients (85 male, 110 female) with mean age of 31±14 (range 7-71) years underwent chalazion excision. Mean duration of presenting symptoms was 4±2.8 (range 1-24) months. Chalazia were single in 172 (88.2%) and multiple in 23 (11.8%) patients. Single chalazia were distributed almost identically in medial, central and lateral sites of lids. Mean difference of pre- and postoperative best-corrected visual acuity was 0.0004 LogMAR (P=0.3). Mean differences in pre- and postoperative values of sphere, difference in keratometry (DK) or cylinder and spheric equivalent (SE) were 0.005 D (P= 0.9), 0.17 D (P<0.001) and 0.006 D (P= 0.08), respectively. Mean differences between pre- and postoperative topographic indices including surface regularity index, surface asymmetry index, keratometry (D) and potential visual acuity (LogMAR) were 0.13 (P<0.0001), 0.09 (P<0.0001), 0.34 (P<0.0001) and 0.05 (P<0.0001), respectively. In comparison of single-central-firm chalazion with multiple-peripheral-soft type chalazia, the difference in mean DK was 0.53±0.15 D (P<0.0001) and the difference of mean changes of SE was 0.45±0.11 D (P=0.2). Mean difference of DK was 0.1±0.06 D in upper lid (P= 0.03) and 0.02±0.03 in lower lid (P=0.1). Excision of chalazion can decrease corneal astigmatism and irregularity, which is more prominent in single-central-firm and upper lid chalazia. In children who are at risk of amblyopia, any attempt to improve the refractive state is worthwhile.