Changes in Tear Meniscus Analysis After Ptosis Procedure and Upper Blepharoplasty

Abstract

Introduction To quantitatively evaluate dry eye test and tear measurements following oculoplastic surgery.

Methods This comparative prospective clinical study comprised three groups of adult patients: the 1) blepharoplasty group: those with dermatochalasis; and 2) the blepharoplasty + Muller's muscle-conjunctival resection and 3) blepharoplasty + anterior levator resection groups: those with dermatochalasis and ptosis showing significant improvement after 10% phenylephrine administration. Ocular Surface Disease Index, tear film break-up time, corneal staining, and Schirmer test values were recorded. Tear meniscus area and height were measured using anterior segment-optical coherence tomography.

Results This study comprised 56 patients (18 males, 38 females). The blepharoplasty group included 40 eyes of 20 patients. The blepharoplasty + MMCR group included 21 eyes of 16 patients. The blepharoplasty + ALR group included 30 eyes of 20 patients. No significant differences resulted between the preoperative and postoperative dry eye test and tear measurements in the blepharoplasty group (P > 0.005/for all). Significant increases were seen in the corneal staining, TMH, TMA, and Schirmer test values were significantly decreased compared to those postoperatively in the blepharoplasty + MMCR group (P=0.018, P < 0.001, P=0.033 and P=0.030, respectively). In the blepharoplasty + ALR group, the TMH and TMA were significantly decreased (P=0.031, P=0.036).

Conclusion No changes resulted in dry eye tests following blepharoplasty in patients without dry eye symptoms. Changes were more pronounced following ptosis surgery, especially MMCR. Patients should be carefully examined for dry eye and treated during follow-up.