Dry Eye Symptoms and Chemosis Following Blepharoplasty

Prischmann, Jess; Ahmed, Sanaa; Ting, Jonathan Y.; Ruffin, Chad; Perkins, Stephen W.

doi:10.1001/archfacial.2013.1

Cited by 4 publications

(6 citation statements)

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“…Dry eye symptoms were recorded to determine whether there was an association with distances measured. There were 25 cases (30.5%) of new-onset dry eye symptoms in the first 3 months, which is similar to numbers reported in a previous study, 28 but no association was found with the change in distance. This finding supports that the eyelid position changes were of little clinical significance.…”

Section: Discussionsupporting

confidence: 89%

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Sultan¹,

Genther

Perkins

2016

JAMA Facial Plast Surg

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IMPORTANCETranscutaneous lower eyelid blepharoplasty is a commonly performed procedure with a postoperative risk of eyelid malposition.OBJECTIVE To quantify the change in lower eyelid position after transcutaneous lower eyelid blepharoplasty. DESIGN, SETTING, AND PARTICIPANTSThis retrospective medical record review describes patients who underwent transcutaneous blepharoplasty at a private facial plastic surgery practice. Patients with less than 3 months of follow-up, a history of periocular trauma, and concurrent midface lift were excluded.INTERVENTIONS Bilateral skin-muscle flap lower eyelid blepharoplasties with possible tarsorrhaphy, canthopexy, or canthoplasty as indicated.MAIN OUTCOMES AND MEASURES Lower eyelid position determined by measurement of preoperative and postoperative pupil to eyelid and lateral limbus to eyelid distances.RESULTS Data from 100 consecutive patients (mean age, 56.7 years; 92 female [92.0%]) undergoing bilateral skin-muscle flap lower eyelid blepharoplasty were analyzed. The mean increase in distance was 0.33 mm (95% CI, 0.24-0.42 mm) from the pupil to the lower eyelid margin and 0.32 mm (95% CI, 0.23-0.41 mm) from the lateral limbus to the lower eyelid margin at final follow-up. For both measurements, patients undergoing concurrent canthopexy had a significantly greater change in eyelid position (P < .001). Men had a greater change in the distance of pupil to lower eyelid compared with women (0.76 mm; 95% CI, 0.44-1.08 mm, vs 0.30 mm; 95% CI, 0.20-0.39 mm, respectively; P = .008) at final follow-up. Two patients required revision procedures secondary to eyelid malposition, and 25 patients had new onset of dry eye symptoms.CONCLUSIONS AND RELEVANCE Transcutaneous skin-muscle lower eyelid blepharoplasty with selective performance of canthoplasty or canthopexy causes a small, predictable eyelid position change in this population with a low rate of revision procedures.LEVEL OF EVIDENCE 3.

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Section: Discussionsupporting

confidence: 89%

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Sultan¹,

Genther

Perkins

2016

JAMA Facial Plast Surg

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“…Eyelid surgery that causes the onset of dry eye disease or worsening of preoperative dry eye complaints is thought to be common but underreported (19) . The incidence of dry eye symptoms following cosmetic blepharoplasty has been reported to be 0%-26.5% (3,20) . According to a 10-year single-center retrospective study, of 892 patients undergoing blepharoplasty, 26.5% reported dry eye symptoms at some point after surgery (3) .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of dry eye symptoms following cosmetic blepharoplasty has been reported to be 0%-26.5% (3,20) . According to a 10-year single-center retrospective study, of 892 patients undergoing blepharoplasty, 26.5% reported dry eye symptoms at some point after surgery (3) . Among them, combined upper and lower eyelid blepharoplasty (31.3%) was more likely to cause dry eye symptoms than upper eyelid blepharoplasty (12.9%) and lower eyelid blepharoplasty alone (21.4%).…”

Section: Discussionmentioning

confidence: 99%

“…They noted that 0%-73% of patients continued to have persistent dry eye after the initial 30 days following surgery, mostly in the 0%-10% range (21) . Although some studies suggested a causal relationship between dry eye disease and blepharoplasty (2)(3)(4)22) , they are limited in estimating the true incidence of dry eye disease after upper eyelid blepharoplasty because of their retrospective design, nonstandard surgery technique, the inclusion of both upper and lower eyelid blepharoplasties with or without additional procedures, or the use of mostly patient-reported symptomatology for diagnosing dry eye disease rather than supporting it with ocular surface findings and comprehensive tear function tests. In this study, which included patients undergoing upper eyelid blepharoplasty with skin and partial orbicularis excision, we noted a significant increase in the OSDI and corneal fluorescein and lissamine green staining scores and a significant decrease in TBUT after surgery compared with those at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Upper eyelid blepharoplasty improves patients' quality of life by improving visual function and esthetic outcome (1) . Several retrospective studies, most of which included both upper and lower eyelid blepharoplasties, have reported increased dry eye complaints following blepharoplasty (2)(3)(4) . The concept that upper eyelid blepharoplasty alone with skin and orbicularis excision leads to dry eye symptoms has not been clearly confirmed by prospective studies in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Effect of upper eyelid blepharoplasty on the ocular surface, tear film, and corneal microstructure

Aygun,

Arat,

Dikmetas

et al. 2024

ABO

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This study aimed to investigate the effect of upper eyelid blepharoplasty with the removal of the skin and a strip of orbicularis oculi muscle on the ocular surface, tear film, and dry eye-related symptoms. Methods: Twenty-two eyes of 22 consecutive patients operated by a single surgeon (21 females; mean age, 61 years; age range, 41-75 years) were included. All subjects completed the Ocular Surface Disease Index questionnaire, underwent in vivo confocal microscopy, tear film breakup time measurements, the Schirmer test with anesthesia, and fluorescein and lissamine green staining measurements before, 1 month, and 6 months after upper blepharoplasty alone with preseptal orbicularis excision. Results: A significant increase in Ocular Surface Disease Index, and corneal fluorescein and lissamine green staining and a significant decrease in tear film breakup time were observed after 1 month (p=0.003, p=0.004, p=0.029, and p=0.024 respectively) and 6 months (p=0.001 for all findings). No significant difference in the Schirmer test score was observed during the follow-up. None of the in vivo confocal microscopy parameters showed significant changes during the study. Conclusions: An increase in dry eye symptoms and a decrease in tear film stability along with ocular surface staining were observed in patients undergoing upper eyelid blepharoplasty.

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Study to the Effect of Involutional Blepharoptosis Surgery Using Objective and Subjective Parameters

et al. 2022

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Background We investigate the effect of involutional blepharoptosis (IB) surgery based on dry eye symptoms by analysis using objective and subjective measures. Methods We recorded various parameters from patients that underwent levator advancement surgery for IB, totaling 125 eyes (total 65 patients, 5 unilateral, 60 bilateral). Subjective assessment comprised a questionnaire on dry eye-related quality of life score (DEQS), a summary score calculated from DEQS, and six-grade evaluation, the patient's own measure of eye comfort. Objective assessment comprised marginal-reflex distance-1 (MRD-1), measurement of tear film breakup time, and superficial keratopathy (SPK) existence by slit lamp microscope. Results Subjective assessments showed that IB patients had improvement of dry eye symptoms and eye comfort when surgery increased MRD-1. On the other hand, objective assessments showed that the presence of SPK is suspected when the postoperative MRD-1 level is 3 mm or higher. Conclusion IB surgery must not only increase MRD-1 value, but also to perform maintenance of the appropriate ocular surface condition. From our parameters, we suggest postoperative MRD-1 value should be maintained at < 3 mm to safe and effective of IB surgery.

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Dry Eye Symptoms and Chemosis Following Blepharoplasty

Cited by 4 publications

References 0 publications

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Effect of upper eyelid blepharoplasty on the ocular surface, tear film, and corneal microstructure

Study to the Effect of Involutional Blepharoptosis Surgery Using Objective and Subjective Parameters

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