Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

Abstract

Background: Large full-thickness eyelid defects are conventionally reconstructed by either a Hughes flap or Cutler-Beard bridge flap. Since the structure of the eyelid and its components are necessary for the tear film production and stability, we investigated the outcome after eyelid reconstruction focusing on dry eye symptoms using a new thermographic device, the TG-1000. Methods: Seventeen eyes of patients formerly treated with Hughes flaps (n = 16) and a Cutler-Beard bridge flap (n = 1) were compared to untreated healthy eyes (n = 17) regarding the functional and aesthetic outcome. The follow-up ranged from 3 to 63 months (mean 24.88 ± 17.86). Results: There was no significant difference in Schirmer’s test, break-up time and ocular surface temperature (p > 0.05) between patients after full-thickness eyelid reconstruction and a control group. Eleven patients had minor postoperative complications such as notching of the lid margin (11/17), epiphora (1/17), superficial punctate keratitis (6/17), trichiasis (2/17) and a mild tendency to eversion of the lid margin (6/17). More than 75% of the patients rated their postoperative aesthetic outcome as good or even excellent. Conclusion: The new TG-1000 device is a simple and quick tool for screening of dry eye. This study shows that tarsoconjunctival grafts offer good aesthetic and functional outcome with sufficient tear film composition and stability.

Application of infrared thermography in computer aided diagnosis

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“…These temperature changes can be linked to eye diseases, such as dry eye and dry eye after eye lid reconstruction [178]. Therefore, this technique is beginning to play an important role in the field of ophthalmology [179].…”

Evaluation of Allergic Conjunctivitis by Thermography

“…We have demonstrated that the temperature of a functional bleb is lower than that of a non-functional bleb [11], and the temperature of the corneal surface in eyes with the dry eye syndrome is lower than that in normal eyes [13]. It has also been reported that thermography is useful in evaluating bacterial corneal ulcers or the effect of reconstruction of lagophthalmos [26,27]. …”

Evaporative dry eye following modified Hughes flap reconstruction

“…The modified Hughes tarsoconjunctival flap is widely used for posterior lamella repair during full‐thickness lower eyelid reconstruction, following tumour excision or trauma . The flap bisects the meibomian glands in the upper tarsal plate and places the donor flap into the lower eyelid defect . However, the effects of this procedure on tear film function have not yet been fully established …”