The Effect of Eyelid Laxity on Corneal Mapping and Corneal Topography

Purpose To evaluate the effect of eyelid laxity on the structure of the cornea. Methods This was a retrospective study performed in one institution. Patients with and without upper and lower eyelid laxity, which were determined using the snap-back test (SBT) and the upper eyelid distraction test (LDT), were evaluated for corneal structural changes with Scheimpflug imaging corneal tomography for the keratometric readings, and cor-neal spectral domain optical coherence tomography for the epithelial thickness (ET) measurements. The ET values were obtained using the statistics report for the superior quadrant (SET), the inferior quadrant (IET) within the 2- to 7-mm region, and central thickness (CET) within the 2-mm region. The minimum corneal thickness values within the central 5-mm region (MinCT) were also included in the study. Keratometric readings (in diopters), horizontal white-to-white (HWTW) measurements, pachymetry, and ET measurements were assessed along with the presence or absence of eyelid laxity. Results A total of 170 eyes from 85 patients were evaluated (50.6% with eyelid laxity, and 49.4% without eyelid laxity). There was no significant difference between the mean keratometric readings, HWTW, and the mean IET and CET values ( P > .05); however, the difference was significant for the MinCT and SET ( P < .05). A statistically significant negative correlation was found between the SET values and age, LDT, and SBT measurements ( P < .05). Conclusions A strong association was found between decreased SET and MinCT values and eyelid laxity. The possible reason for these decreases may be inflammation, which plays a role in the pathophysiology of eyelid laxity. [ J Refract Surg . 2024;40(11):e783–e791.]