Evaluation of short-term cornea parameter changes after involutional entropion and ectropion surgery

The aim of this study was to evaluate the effects of entropion and ectropion surgery on refractive values, corneal thickness, endothelial cell morphology assessed by specular microscopy, and corneal parameters obtained with Pentacam topography, comparing preoperative and postoperative measurements. A total of 31 eyes from 25 patients aged 65–93 years who underwent lower eyelid surgery for entropion or ectropion at Tokat Gaziosmanpaşa University between February and July 2025 were prospectively included. Autorefractometry, specular microscopy, and Pentacam measurements were performed preoperatively and at postoperative week 1, month 1, and month 2. Patients who underwent entropion surgery (Group 1) and those who underwent ectropion surgery (Group 2) were evaluated both within and between groups. Surgical techniques included the Jones procedure, everting sutures, and lateral tarsal strip for entropion cases, and wedge resection, lateral tarsal strip, medial ectropion correction, and punctoplasty for ectropion cases when indicated. The study included 18 males and 7 females with a mean age of 74.26 ± 6.37 years. No significant age difference was found between the two diagnostic groups; however, female patients were significantly older than male patients (p < 0.05). Keratometric parameters (K1, K2, Kmax), astigmatism magnitude, and aks showed no significant pre- to postoperative changes in either group (p > 0.05). Although with-the-rule astigmatism increased postoperatively, aks shifts were not significant. RminFront values showed no significant overall pre/post difference, but a significant increase was observed between postoperative week 1 and months 1 and 2 (p < 0.05). In the entropion group, PAKI Pupil Center thickness significantly decreased at postoperative month 2 (p < 0.05). No significant change was detected in other PAKI parameters or anterior chamber angle/depth measurements. Surface irregularity indices revealed no significant change in ISV across all time points; however, a significant decrease was observed between postoperative week 1 and month 2 (p < 0.05). IVA, KI, CKI, IHA, and IHD did not show significant changes, however, IHD values remained above the normal range at all time points. Pachymetric progression indices, Belin–Ambrosio ectasia risk index, and anterior/posterior elevation thicknesses did not show significant postoperative change. Specular microscopy showed stable CCT, ECD, and CV values postoperatively (p > 0.05). In the entropion subgroup, the HEX value increased significantly at postoperative week 1 (p < 0.01) and remained elevated—though not significantly—at later visits. It has been observed that entropion and ectropion surgery do not cause significant changes in corneal keratometric parameters; however, they may result in a slight flattening tendency on the anterior corneal surface and a micro-level improvement in surface regularity. The elimination of mechanical stress following lower eyelid surgery is considered to be a factor that may exert beneficial effects on endothelial cell morphology, particularly in cases of entropion. Keywords: entropion, ectropion, corneal topography, specular microscopy