Objective: To evaluate the changes of visual acuity, contrast sensitivity, astigmatism, and higher order aberrations after blepharoplasty in patients with dermatochalasis. Methods: Two hundred six eyelids of 103 patients with dermatochalasis were prospectively studied. Visual acuity, contrast sensitivity, corneal topography, astigmatism degree, and higher order aberrations were examined and recorded before and at 1 month after upper eyelid blepharoplasty. Change in contrast sensitivity and astigmatism values were determined according to margin reflex distance of patients, which were classified into three following groups: <2 mm, 2–3 mm, and ⩾ 4 mm. A Wilcoxon signed rank test was performed to compare the difference. Results: No significant differences were observed for visual acuity (p = 0.157). The contrast sensitivity of patients significantly increased at all spatial frequencies both under glare and nonglare conditions (p < 0.05). The mean refractive astigmatism significantly decreased from ‒1.01 ± 1.3 to ‒0.79 ± 0.71, postoperatively (p = 0.029). In patients with marginal reflex distance < 2 mm, mean contrast sensitivity was increased (p < 0.001) and mean astigmatism was decreased significantly (p < 0.001) compared with those with ⩾ 2 mm. Higher order aberrations decreased significantly from 0.62 ± 0.41 µm to 0.55 ± 0.38 µm (p = 0.038) after blepharoplasty. Root mean square of the vertical trefoil (p = 0.038), vertical coma (p = 0.002), horizontal trefoil (p = 0.027), third-order aberration (p = 0.005), secondary vertical stigmatism (p = 0.001), spherical aberration (p = 0.023), secondary horizontal astigmatism (p = 0.002), fourth-order aberration (p = 0.024), vertical pentafoil (p = 0.015), secondary horizontal coma (p = 0.035), secondary horizontal trefoil (p = 0.030), and horizontal pentafoil (p = 0.048) were decreased significantly. Conclusion: Upper eyelid blepharoplasty in patients with dermatochalasis has a significant improvement in visual function in terms of contrast sensitivity, astigmatism, and higher order aberrations.

The purpose of this study was to present surgical techniques for the reconstruction of medial canthal defects with and without the involvement of the eyelid. This study included 31 patients who underwent medial canthal reconstruction after tumor excision during a 6-year period. Data regarding patient demographics, defect size, tumor pathology, surgery techniques, functional and cosmetic outcomes, and complications were recorded. The reconstructive methods used in the study were divided into groups as per the site of the defect (medial canthal, medial canthal with upper eyelid, medial canthal with lower eyelid, and medial canthal with both eyelids). The most common histopathological diagnosis of the lesions was basal cell carcinoma (74.2%). Postoperative complications (6.4%) included flap necrosis in one patient and lid margin notching in another. Among patients who underwent reconstruction, 8 (25.8%) had only medial canthal defect, 6 (19.3%) had medial canthal defect extending to the upper eyelid, 7 (22.6%) had medial canthal defect extending to the lower eyelid, and 10 (32.3%) had medial canthal defect extending to both the eyelids. The functional outcome was regarded as normal in 30 (96.8%) patients and limited in 1 (3.2%) patient. Cosmetic outcomes were satisfactory in all the patients. The use of alternative reconstructive approaches for different subunits of the medial canthus is an efficient method to achieve superior functional and cosmetic outcomes.

Purpose To compare quality of life (QoL) in patients with primary open-angle glaucoma (POAG) and dry-type age-related macular degeneration (AMD) with similar bestcorrected visual acuity. Methods Age-, sex-, and visual acuitymatched POAG and dry AMD patients were included in the study. Each patient performed 24-2 and 10-2 SITA standard visual field tests. Contrast sensitivity was evaluated with CSV-1000 HGT instrument. The 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was used to analyze QoL. Overall and subscale scores were converted to scores between 0 and 100, the higher scores indicating better visionrelated QoL. Results Overall NEI-VFQ-25 scores were 86.44 and 84.66 in glaucoma and AMD groups, respectively (P = 0.244). The highest scores were obtained in 'vision-related dependency' subgroup in glaucoma and 'color and peripheral vision' in AMD group, whereas the lowest scores were noted 'in peripheral vision' in both glaucoma and AMD patients. Glaucoma patients had significantly lower scores in ocular pain, color vision, and peripheral vision subgroups compared with the AMD group, whereas AMD patients had lower scores in near and distance vision activities, vision-related social activity, and dependency subgroups. Contrast sensitivity results and mean defect values showed correlation with NEI-VFQ-25 scores in both groups. Conclusions Glaucoma and AMD patients with similar visual acuity experienced similar overall impairment in QoL. However, glaucoma patients described more difficulty with peripheral vision and ocular pain, whereas AMD patients complained more about near and distance vision and dependency items.

The aim of this study is to assess the etiologic factors of primary dacryocystorhinostomy (DCR) failure according to DCR techniques and also to determine risk factors for the prediction of failure in revision external DCR. Retrospective review was performed in patients who underwent revision external DCR for previous DCR failure between 2008 and 2018. All patients underwent full ophthalmic and intranasal examination, lacrimal probing, and irrigation. Patients were classified into following groups according to previous DCR type: external, endoscopic endonasal, and transcanalicular laser DCR. Potential etiologic factors were compared between 3 groups. Multivariate analysis was performed to identify risk factors for failure in revision external DCR. About 115 eyes from 109 patients constituted the external (50.4%), endonasal (31.3%), and laser (18.3%) DCR groups. Among 27 (23.5%) patients with intranasal pathologies, septal deviation (33.3%) is the most common finding. The commonest cause of failure was inadequate ostium size in external (37.9%), endonasal (36.1%), and laser (66.7%) DCR groups. Inadequate ostium size and cicatricial lacrimal ostium scarring were observed significantly more common in the laser (P = 0.047) and external DCR group (P = 0.043), respectively. The success rate for revision external DCR was 85.2%. Canalicular or common canalicular obstruction (P = 0.032), intranasal pathology (P = 0.003), and bilateral obstruction (P = 0.025) demonstrated a significant independent association with failure in revision external DCR. Inadequate ostium size was the most common cause of failure in primary external, endonasal, and laser DCR. Canalicular or common canalicular obstruction, intranasal pathology, and bilateral lacrimal obstruction were significant predictors of failure in revision external DCR.

Objective: To investigate the effects of ocular prosthesis on meibomian glands and also to identify the role of meibomian gland dysfunction (MGD) on ocular discomfort in prosthetic eyes. Methods: This prospective study included 55 patients who had been wearing unilateral ocular prosthesis for more than 1 year. A 15-item questionnaire regarding MGD-related ocular symptoms was administered to all patients. Both prosthetic eyes and paired normal eyes were evaluated with slit-lamp, noncontact meibography and spectral optical coherence tomography. A multiple linear regression model was applied to evaluate factors on ocular symptom scores. Results: The ocular symptom scores, meibography scores, meibomian gland loss, and lid margin abnormality scores of prosthetic eyes were significantly higher than those of normal eyes (P<0.05). Tear meniscus measurements of eyes with prosthesis were significantly lower from those of normal eyes (P<0.05). The ocular symptom scores were significantly positively correlated with meibography scores, meibomin gland loss, and lid margin abnormality scores and negatively correlated with tear meniscus measurements (P<0.05). There was a significant negative correlation between total meibography scores and all tear meniscus parameters (P<0.05). The patients who had used ocular prosthesis for longer durations had a significantly greater meibography scores, meibomin gland loss, lid margin abnormality scores, and ocular symptom scores but lesser tear meniscus parameters (P<0.05). Conclusion: Use of ocular prosthesis is significantly associated with MGD, which is proportional to the duration of prosthesis wear. Furthermore, ocular discomfort symptoms of prosthetic eye wearers significantly correlated with MGD-related dry eye.

Objective: We sought to evaluate ocular surface changes in patients with Hashimoto's thyroiditis without thyroid ophthalmopathy and elucidate the relationship between dry eye syndrome and meibomian gland dysfunction (MGD) in cases of Hashimoto's thyroiditis. Methods: This prospective study included 105 patients with Hashimoto's thyroiditis and 105 age- and sex-matched controls. The 12-item Ocular Surface Disease Index (OSDI) questionnaire was administered to all patients. Both eyes affected by Hashimoto's thyroiditis and normal eyes were evaluated and compared with regard to the following parameters: Hertel exophthalmometry, palpebral fissure height, tear-film breakup time (TBUT), Schirmer 1 test, area and density scores for corneal fluorescein staining, eyelid abnormality, meibomian gland expression, meibography scores, and areas of meibomian gland loss. Results: The eyes affected by Hashimoto's thyroiditis demonstrated significantly lower TBUTs (P<0.001), Schirmer 1 test scores (P<0.001), and meibomian gland expression (P<0.05) and significantly higher OSDI scores (P<0.001), corneal fluorescein staining results (P<0.05), eyelid abnormality scores (P<0.05), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05). Ocular Surface Disease Index scores were significantly positively correlated with eyelid abnormality scores (P=0.025), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05) and negatively correlated with meibomian gland expression (P<0.05). The duration of Hashimoto's thyroiditis was significantly positively correlated with MGD (P<0.05). Conclusion: Dry eye syndrome and ocular discomfort symptoms are significantly more common among patients with Hashimoto's thyroiditis, even in the absence of thyroid ophthalmopathy. Dry eye syndrome in patients with Hashimoto's thyroiditis is believed to result from MGD and is correlated with the duration of the thyroid disease.

Clinically significant ocular toxicity is not frequently encountered in breast cancer patients, however, SWAP changes may occur early after tamoxifen utilization.

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