Corneal biophysical changes after upper eyelid blepharoplasty and ptosis surgery: a review

Abstract

Upper eyelid surgeries, such as blepharoplasty and ptosis correction, are commonly performed procedures worldwide. This review examines the effects of these surgeries on ocular properties and visual function. A search of the PubMed and Google Scholar databases was conducted to identify relevant articles published after 2000. The results demonstrate that the ocular and adnexal organs function as a unified visual system, with changes in one component affecting the functions of others. Eyelid surgery can alter ocular properties and functions by modifying retinal lighting and ocular optics. These alterations can affect intraocular pressure estimation, corneal curvature, corneal epithelial thickness, refractive power of the cornea, and intraocular lens calculation. Additionally, eyelid surgery can exacerbate dry eye symptoms and impact contrast sensitivity, which is a significant factor in visual quality. Therefore, understanding these interactions is crucial before performing eyelid surgery and during follow-up. This review summarizes recent literature on the effects of upper eyelid surgery on corneal properties and visual function, emphasizing the importance of considering these factors when planning or undergoing such procedures.

The Effects of Blepharoptosis Surgery on Meibomian Gland, Tear Film, and Corneal Topography

“…Many other studies after blepharoptosis surgery have also reported the effects of this surgery on refractive corneal topographic measurements ( 6 , 17 , 22 - 28 ). In addition, before making any further decisions, it is advised to wait 3 months after blepharoplasty surgery to repeat corneal topography and refraction because post-operative eyelid edema can persist for up to 2 months after the procedure ( 6 , 20 ).…”

“…However, these findings not being significant may also be related to the small sample size. In addition, some studies reported that additional factors such as higher astigmatism in the pre-operative period, severity of ptosis level, and deep superior sulcus were associated with higher corneal astigmatism changes in the postoperative period ( 6 ).…”

“…Dry eye symptoms, an important post-eyelid surgery observation, may also worsen after blepharoptosis surgery due to various factors, including post-operative inflammation, chemosis, lagophthalmos, excessive orbicular denervation and resection, lid retraction, and dysfunction of the lacrimal pump system. It is known that these symptoms may be transient in the first few weeks and will likely resolve within 2–3 months after surgery ( 5 , 6 ). However, it should be noted that gland orifice migration or subclinical gland inflammation could also contribute to this pathophysiology ( 7 ).…”