Discussion
LMS, amblyopia, astigmatism, corneal astigmatism, epiblepharon, corneal epithelial lesions
AMBLYOPIA, ASTIGMATISM, RECURRENCE
We conducted the first randomized clinical trial (RCT) of epiblepharon to accurately evaluate the effectiveness and safety of incisional and suture techniques. In this study, only patients with grade 2 moderate epiblepharon, following the classification proposed by Lee et al.At 6 months after surgery, surgical outcomes in this study were classified as well-corrected in 77.8% of cases of incision and 54.5% of cases of suture, confirming the effectiveness of the techniques for treating epiblepharon. According to previous studies, the recurrence rate for incision techniques was 0%–9.1%This study revealed that the incisional technique was statistically superior to the suture technique in terms of the number of cases with well-corrected outcomes at 6-month follow-up. Although there have been several reports on these two major surgical techniques, the differences in clinical outcomes between the two techniques and the indication of the surgical techniques have rarely been evaluated. Sunder et al. retrospectively reviewed the two techniques; however, no statistical analysis was performed due to the small number of casesRefractory corneal epithelial lesions caused by epiblepharon can induce corneal astigmatism and result in amblyopia in severe cases. The effect of surgical correction on reducing the extent of astigmatism in patients with epiblepharon is controversialCompared with the incision technique, the suture technique is minimally invasive and requires less operative time; therefore, performing surgery under local anesthesia on young patients might be possible. Thus, the suture technique may be appropriate for treating mild cases and surgery under local anesthesia.This study has several limitations. First, this RCT included only patients with moderate epiblepharon (Grade II). Hence, the results of this research portray moderate epiblepharon rather than all epiblepharon. LMS, which is considered effective in reducing recurrence, was performed in all cases for the incision technique