The effect of upper eyelid blepharoplasty on corneal topography and higher-order optical aberrations

To evaluate the effects of upper eyelid blepharoplasty on corneal topography and higher-order optical aberrations (HOAs).

Seventy-seven patients (154 eyes) who underwent upper eyelid blepharoplasty for dermatochalasis and had complete preoperative and 3-month postoperative corneal topography and aberrometry data were included. All measurements were obtained using the Sirius topography system. Aberrometric parameters-including total RMS, HOA RMS, coma, trefoil, and spherical aberration-as well as advanced topographic indices such as EIf, EIb, TSI, and TImax were analyzed. As this was a retrospective observational study, trial registration was not applicable.

No statistically significant change was observed in total RMS values. At a 6 mm pupil diameter, HOA RMS decreased from 0.53 ± 0.25 to 0.49 ± 0.17 (p = 0.014), and coma decreased from 0.31 ± 0.20 to 0.27 ± 0.14 (p = 0.002). Spherical aberration also showed a postoperative reduction (0.23 ± 0.10 to 0.21 ± 0.10; p = 0.008). Significant improvements were detected in trefoil (p < 0.001), TImax (p < 0.001), EIf (p < 0.001), EIb (p = 0.008), and TSI (p = 0.005). No significant postoperative differences were observed in keratometric values or secondary astigmatism (p > 0.05).

Upper eyelid blepharoplasty appears to produce beneficial changes in corneal surface morphology and optical aberrations. Given its potential to enhance visual quality and patient satisfaction, the functional implications of blepharoplasty should be considered alongside its aesthetic goals during surgical planning.