Changes in Corneal Curvature After Upper Eyelid Surgery Measured by Corneal Topography

To analyze corneal curvature changes (eg, central corneal power and corneal astigmatism) after upper eyelid surgery, and to compare the effects of different upper eyelid procedures on corneal curvature.

Fifty eyes of 34 patients with various degrees of dermatochalasis or ptosis underwent corneal topography before surgery, and at 6 weeks after blepharoplasty or levator resection. Patients were divided into groups according to the method of surgery. Preoperative and postoperative changes in corneal curvature of each operated eye were compared within each group.

At 6 weeks after levator resection, 50% of the eyes showed an increase in corneal power, 34.6% showed a decrease, and 15.4% showed no change. The corneal astigmatism in 50% of eyes with levator resection decreased, increased in 19.2% of eyes, and showed no change in 30.8% of eyes. At 6 weeks after blepharoplasty, 12.5% of the eyes showed an increase in corneal power, 37.5% showed a decrease, and 66.7% showed no change. Regarding corneal astigmatism in patients who underwent blepharoplasty, 16.7% of the eyes decreased, 16.7% increased, and 66.6% showed no change. Comparing eyes treated with the 2 surgical techniques, there was a statistical difference in the percentage eye which showed corneal diopter and astigmatism change using these 2 techniques (P < 0.05).

Repositioning of the upper eyelid after levator resection showed greater changes of corneal curvature (eg, central corneal power and corneal astigmatism) than blepharoplasty. The advanced aponeurosis technique may have a greater effect on the lid/cornea interface, by lifting the eyelids pressing against the eyeball to affect corneal curvature.