Changes in Corneal Biomechanics and Wavefront Following Eyelid Surgery

Introduction: This study evaluated corneal biomechanics and wavefront aberrations in patients with eyelid masses and documented changes in these parameters following surgical excision in a Northwest Indian population through a prospective interventional study. Methods: Twenty eyes of 20 patients requiring surgical excision of eyelid masses were enrolled. Preoperative and postoperative assessments included a comprehensive ocular examination, corneal biomechanics evaluation using an ocular response analyzer, and wavefront aberrometry with the I-Trace system. Results: Corneal biomechanics were assessed preoperatively and postoperatively in all patients. No statistically significant changes were observed in corneal hysteresis or corneal resistance factor following surgery, regardless of lesion location in the upper (P=0.458) or lower eyelids (P=0.154). Similarly, wavefront aberrations, including lower-order aberrations (LOAs), higher-order aberrations, spherical aberrations (SAs), coma, and trefoil, showed no significant postoperative differences overall. However, patients with lesions ≥5 mm in size exhibited significant changes in astigmatism, SAs (P=0.008), coma (P=0.050), and total LOAs (P=0.049) postoperatively. Patients with lesions ≥5 mm demonstrated significant postoperative changes in selected corneal wavefront parameters, whereas no significant changes were observed in corneal biomechanical parameters. Conclusion: Surgical excision of larger eyelid masses (≥5 mm) is associated with significant postoperative changes in corneal wavefront parameters, particularly in astigmatism, SAs, coma, and LOAs, while corneal biomechanics remain stable. This highlights the role of lesion size in influencing corneal wavefront changes, warranting further investigation in larger cohorts.