Abstract
Purpose
To analyze the corneal morphological parameters before and one month after the upper eyelid (UE) blepharoplasty and external levator resection (ELR) for ptosis surgery.
Materials and Methods
Seventy eyes of 70 patients with dermatochalasis (50 eyes) and acquired aponeurotic ptosis (AAP) (20 eyes) included in this prospective study. Detailed ophthalmologic examination was performed including the best corrected visual acuity (BCVA), slit lamp examination and dilated fundoscopy. Measurements were made before and one month after the surgeries using Pentacam. Central corneal thickness (CCT), pupil center pachymetry (PCP) and thinnest pachymetry (TP), cornea front astigmatism (AST), flat keratometry (K1), steep keratometry (K2) and mean keratometry (Km) values were evaluated.
Results
Higher postoperative Km measurements were observed in dermatochalasis (p = 0.038) patients. Postoperative AST values were significantly lower in both dermatochalasis and ptosis cases (p = 0.034, p = 0.003, respectively). Increased PCP and TP were found in the AAP patients (p = 0.014, p = 0.015, respectively).
Discussion
UE blepharoplasty and ELR surgeries both lead to some significant changes on corneal structure post-operatively.
Level of Evidence IV
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References
Aksu Ceylan N, Yeniad B (2022) Effects of upper eyelid surgery on the ocular surface and corneal topography. Turkish J Ophthalmol 52(1):50–56. https://doi.org/10.4274/tjo.galenos.2021.63255
Mongkolareepong N, Mekhasingharak N, Pimpha O (2022) Factors associated with corneal astigmatism change after ptosis surgery. Int J Ophthalmol 15(4):576–580. https://doi.org/10.18240/ijo.2022.04.08
Kim YK, In JH, Jang SY (2016) Changes in corneal curvature after upper eyelid surgery measured by corneal topography. J Craniofac Surg 27(3):e235–e238. https://doi.org/10.1097/SCS.0000000000002435
van den Bosch WA, Leenders I, Mulder P (1999) Topographic anatomy of the eyelids, and the effects of sex and age. Br J Ophthalmol 83(3):347–352. https://doi.org/10.1136/bjo.83.3.347
Ching JA, Ford JM, Decker SJ (2020) Aging of the adult bony orbit. J Craniofac Surg 31(4):1082–1085. https://doi.org/10.1097/SCS.0000000000006311
Camirand A, Doucet J (1996) Surgical advances a comprehensive approach to surgical rejuvenation of the eyes. Aesthetic Plast Surg 20(1):15–22. https://doi.org/10.1007/BF02275570
Garcia GA, Ngai P, Vemuri S, Tao JP (2017) Upper eyelid and pupillary effects of topical dilute epinephrine. Ophthalmic Plast Reconstr Surg 33(2):106–111. https://doi.org/10.1097/IOP.0000000000000663
Sridharan GV, Tallis RC, Leatherbarrow B, Forman WM (1995) A community survey of ptosis of the eyelid and pupil size of elderly people. Age Ageing 24(1):21–24. https://doi.org/10.1093/ageing/24.1.21
Nemet AY (2015) Accuracy of marginal reflex distance measurements in eyelid surgery. J Craniofac Surg 26(7):e569–e571. https://doi.org/10.1097/SCS.0000000000001304
Santodomingo-Rubido J, Carracedo G, Suzaki A, Villa-Collar C, Vincent SJ, Wolffsohn JS (2022) Keratoconus: an updated review. Cont Lens Anterior Eye 45(3):101559. https://doi.org/10.1016/j.clae.2021.101559
Read SA, Collins MJ, Carney LG (2007) The influence of eyelid morphology on normal corneal shape. Investig Ophthalmol Vis Sci 48(1):112–119. https://doi.org/10.1167/iovs.06-0675
Assadi FA, Narayana S, Yadalla D, Rajagopalan J, Joy A (2021) Effect of congenital ptosis correction on corneal topography–a prospective study. Indian J Ophthalmol 69(6):1527–1530. https://doi.org/10.4103/ijo.IJO_2650_20
Ozturk Karabulut G, Fazil K (2019) Corneal topographical changes after müller’s muscle-conjunctival resection surgery. Ophthalmic Plast Reconstr Surg 35(2):177–181. https://doi.org/10.1097/IOP.0000000000001203
Arslan N, Kocamış S, Sabur H, Acar M (2022) Evaluation of the effect of dermatochalasis and upper eyelid blepharoplasty surgery on corneal epithelial thickness alterations. Aesthet Plast Surg. https://doi.org/10.1007/s00266-022-03131-y
Aydemir E, Aksoy AG (2022) Changes in tear meniscus analysis after ptosis procedure and upper blepharoplasty. Aesthetic Plast Surg 46(2):732–741. https://doi.org/10.1007/s00266-021-02613-9
Altin Ekin M, Karadeniz US (2020) Prospective analysis of visual function changes in patients with dermatochalasis after upper eyelid blepharoplasty. Eur J Ophthalmol 30(5):978–984. https://doi.org/10.1177/1120672119857501
Sommer F, Untch E, Spoerl E, Herber R, Pillunat LE, Terai N (2022) Effect of upper eyelid blepharoplasty on corneal biomechanical, topographic and tomographic parameters 4 weeks after surgery. Int Ophthalmol 42(1):113–121. https://doi.org/10.1007/s10792-021-02006-6
Mehlan J, Jonca B, Dulz S, Green S, Spitzer MS, Schüttauf F (2022) Comparative analysis of refractive and topographic changes after eyelid surgery. Ophthalmologe 119(Suppl 1):3–10. https://doi.org/10.1007/s00347-021-01361-0
Kim JW, Lee H, Chang M, Park M, Lee TS, Baek S (2013) What causes increased contrast sensitivity and improved functional visual acuity after upper eyelid blepharoplasty? J Craniofac Surg 24(5):1582–1585. https://doi.org/10.1097/SCS.0b013e318292c5ac
Zinkernagel MS, Ebneter A, Ammann-Rauch D (2007) Effect of upper eyelid surgery on corneal topography. Arch Ophthalmol 125(12):1610–1612. https://doi.org/10.1001/archopht.125.12.1610
Brown MS, Siegel IM, Lisman RD (1999) Prospective analysis of changes in corneal topography after upper eyelid surgery. Ophthalmic Plast Reconstr Surg 15(6):378–383. https://doi.org/10.1097/00002341-199911000-00002
Sinha KR, Al Shaker S, Yeganeh A, Moreno T, Rootman DB (2019) The relationship between eyebrow and eyelid position in patients with ptosis, dermatochalasis and controls. Ophthalmic Plast Reconstr Surg 35(1):85–90. https://doi.org/10.1097/IOP.0000000000001178
Kuo IC (2015) The effect of ptosis on cataract surgical planning. Case Rep Ophthalmol 6(1):132–138. https://doi.org/10.1159/000381846
Aydemir E, Aksoy AG (2023) Ptosis effects on intraocular lens power calculation. J Cataract Refract Surg 49(2):171–176. https://doi.org/10.1097/j.jcrs.0000000000001063
Vola ME, Lisboa R, Diniz ER, Pereira NC, Kanecadan RT, Forseto ADS (2021) Influence of upper blepharoplasty on intraocular lens calculation. Arq Bras Oftalmol 84(1):11–16. https://doi.org/10.5935/0004-2749.20210002
Zloto O, Matani A, Sagiv O et al (2020) Changes in refraction and visual acuity after upper eyelid blepharoplasty versus posterior approach ptosis procedures. Ophthalmic Res 63(6):588–592. https://doi.org/10.1159/000506951
Fowler BT, Pegram TA, Cutler-Peck C et al (2015) Contrast sensitivity testing in functional ptosis and dermatochalasis surgery. Ophthalmic Plast Reconstr Surg 31(4):272–274. https://doi.org/10.1097/IOP.0000000000000307
Belmonte C, Nichols JJ, Cox SM et al (2017) TFOS DEWS II pain and sensation report. Ocul Surf 15(3):404–437. https://doi.org/10.1016/j.jtos.2017.05.002
Lu N, Lin F, Huang Z, He Q, Han W (2016) Changes of corneal wavefront aberrations in dry eye patients after treatment with artificial lubricant drops. J Ophthalmol 2016:1342056. https://doi.org/10.1155/2016/1342056
Zhang SY, Yan Y, Fu Y (2020) Cosmetic blepharoplasty and dry eye disease: a review of the incidence, clinical manifestations, mechanisms and prevention. Int J Ophthalmol 13(3):488–492. https://doi.org/10.18240/ijo.2020.03.18
Li X, Liu C, Mao Z et al (2020) Effect of congenital blepharoptosis on corneal biomechanical properties and changes after ptosis surgery. Eye (Lond) 34(6):1055–1062. https://doi.org/10.1038/s41433-019-0586-9
Dogan AS, Acar M, Kosker M, Arslan N, Gurdal C (2018) Alterations in corneal epithelial thickness in patients with congenital myogenic eyelid ptosis. Int Ophthalmol 38(1):53–57. https://doi.org/10.1007/s10792-016-0419-9
Yunoki T, Hayashi A, Abe S, Otsuka M (2021) Corneal topographic analysis in patients with involutional lower eyelid entropion. Semin Ophthalmol 36(8):599–604. https://doi.org/10.1080/08820538.2021.1890787
Padmanabhan P, Belin MW, Sudhir RR, Mukundan D, Chidambaram H, Ambrósio R (2022) Implications of diagnostic drops on scheimpflug tomography: the proper order for clinical testing. Cornea 41(8):958–964. https://doi.org/10.1097/ICO.0000000000002927
Oishi Y, Manabe I (2018) Macrophages in inflammation, repair and regeneration. Int Immunol 30(11):511–528. https://doi.org/10.1093/intimm/dxy054
Wang PH, Huang BS, Horng HC, Yeh CC, Chen YJ (2018) Wound healing. J Chin Med Assoc 81(2):94–101. https://doi.org/10.1016/j.jcma.2017.11.002
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Acar Eser, N., Serbest Ceylanoglu, K. & Sen, E. Influence of Upper Eyelid Surgeries on Corneal Morphology Detected with Pentacam. Aesth Plast Surg 47, 2432–2439 (2023). https://doi.org/10.1007/s00266-023-03366-3
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DOI: https://doi.org/10.1007/s00266-023-03366-3