The effects of chalazion excision on corneal surface aberrations

• The existence of an upper lid chalazion increases astigmatism and higher order aberrations, especially at the peripheral cornea.
• Significantly induced astigmatism and higher order aberrations are caused by chalazion >5 mm in size.
• We recommend the surgical excision of chalazion >5 mm in size to reduce corneal surface aberrations.

PurposeThis study is the first to consider the effects of chalazion on corneal surface aberrations taking into account of corneal zones, and to establish the size standard for the excision of chalazion.MethodsTwenty three eyes from 23 patients with central upper eyelid chalazion larger than 3 mm were recruited in this prospective study. The participants were classified into two groups, depending on size of the lesion: Group 1 with lesion size 3–5 mm and Group 2 with lesion size >5 mm Chalazion was excised by standard transconjunctival vertical incision. Corneal surface aberrations were measured using a Galilei™ analyzer and an auto-refractometer before and 2 months after the excision.ResultsCorneal astigmatism in all patients decreased significantly in both auto refractometer (P = 0.012) and Galilei™ (P = 0.020) measurements after chalazion excision. RMS of total HOAs decreased significantly in 6 mm (P = 0.043) and 3 mm zone (P = 0.051). The RMS of Zernike orders in the vertical and horizontal trefoil decreased significantly in 6 mm (P = 0.035) and 3 mm (P = 0.041) zone. Group 2 showed a significant decrease in corneal astigmatism in both auto refractometer (P = 0.040) and Galilei™ (P = 0.017) parameters after chalazion excision. Group 1 showed an insignificant decrease in corneal astigmatism. Unlike Group 1, the RMS of total HOAs and vertical and horizontal trefoil in 6 mm zone decreased significantly in Group 2 (P < 0.05).ConclusionsThe existence of an upper lid chalazion increases astigmatism and HOAs, especially at the peripheral cornea. Significantly induced astigmatism and HOAs are caused by chalazion >5 mm in size. Thus, we recommend the surgical excision of chalazion >5 mm in size to reduce corneal surface aberrations.