Changes in Tear Meniscus Analysis After Ptosis Procedure and Upper Blepharoplasty

Area of Science:

• Ophthalmology
• Oculoplastic Surgery

Background:

• Oculoplastic surgery aims to improve eyelid function and aesthetics.
• Dry eye disease is a common concern that can be affected by eyelid surgery.
• Quantitative assessment of ocular surface parameters is crucial after these procedures.

Purpose of the Study:

• To quantitatively evaluate the impact of different oculoplastic surgical procedures on dry eye tests and tear measurements.
• To compare the effects of simple blepharoplasty versus blepharoplasty combined with ptosis correction techniques.

Main Methods:

• A prospective clinical study involving three groups: blepharoplasty, blepharoplasty + Muller's muscle-conjunctival resection (MMCR), and blepharoplasty + anterior levator resection (ALR).
• Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), corneal staining, Schirmer test, tear meniscus height (TMH), and tear meniscus area (TMA) were measured pre- and post-operatively.
• Anterior segment-optical coherence tomography (AS-OCT) was used for TMH and TMA measurements.

Main Results:

• Simple blepharoplasty showed no significant changes in dry eye tests or tear measurements.
• Blepharoplasty + MMCR resulted in increased corneal staining and decreased TMH and TMA, with decreased Schirmer test values.
• Blepharoplasty + ALR led to significant decreases in TMH and TMA.

Conclusions:

• Dry eye tests remain stable after simple blepharoplasty in patients without pre-existing dry eye.
• Ptosis surgery, especially MMCR, can significantly alter tear film parameters and ocular surface integrity.
• Careful pre-operative screening for dry eye and diligent post-operative monitoring are recommended for patients undergoing ptosis surgery.