Effects of Upper Eyelid Blepharoplasty on Contrast Sensitivity in Dermatochalasis Patients

Abstract

Objectives: To evaluate the impact of upper eyelid blepharoplasty on contrast sensitivity in dermatochalasis patients. Materials and Methods: Best corrected visual acuity, ophthalmologic examination, eyelid examination, lash ptosis, contrast sensitivity using sine-wave contrast sensitivity chart, keratometric parameters, and corneal aberrations of 34 eyes of 34 patients who underwent upper eyelid blepharoplasty due to dermatochalasis in our clinic between the years 2014 and 2018 were evaluated preoperatively and at postoperative 3 months. Results: Twenty-three (68%) of the patients were females and 11 (32%) were males. Mean age was 63.1±7 (52-81) years. Mean best corrected visual acuity was 0.036±0.06 (0-0.15) logMAR preoperatively and postoperatively (p>0.05). Contrast sensitivity values of the patients at the frequencies of 1.5, 3, 6, 12, and 18 cycles per degree were 44.38±19.5, 59.03±27.2, 41.44±34.1, 15.15±19.3, and 5.15±4.26 preoperatively and 44.80±20.9, 76.85±33.4, 63.21±46.4, 28.21±31.1, and 10.5±9.5 postoperatively, respectively. The difference between contrast sensitivity values was statistically significant at the frequencies of 3, 6, 12, and 18 cpd (p=0.005, =0.001, <0.001, and <0.001, respectively). Although lash ptosis of the patients improved significantly after the surgery, there was no correlation between lash ptosis improvement and change in contrast sensitivity (p>0.05). Keratometric values and corneal high order aberrations did not change significantly after the surgery (p>0.05). Conclusion: Contrast sensitivity significantly increases after upper eyelid blepharoplasty, especially at higher spatial frequencies which are known to deteriorate due to age-related changes in the lens and retina in older adults. Our results show that blepharoplasty may have additional functional indications for elderly dermatochalasis patients in terms of improving the functions such as performing daily tasks and reading.

Effects of Upper Eyelid Surgery on the Ocular Surface and Corneal Topography

“…As observed by Dogan et al 10 in patients undergoing upper eyelid blepharoplasty, the only significant difference in corneal topography was a change of 0.3 D in K2 values at postoperative 1 month in the group undergoing levator surgery, but this change did not persist at postoperative 3 and 6 months. Similar to the studies by Dogan et al 10 and Nalcı et al 11 , we detected no other significant postoperative changes in other keratometric values.…”

“…Studies have also evaluated the effects of upper eyelid surgery on corneal topography. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 27 In a study by Zinkernager et al 5 , patients undergoing surgery for dermatochalasis or ptosis were divided into three groups according to the surgery performed: ptosis repair by levator surgery, blepharoplasty performed with skin-only removal, and blepharoplasty with skin and fat pad removal. At postoperative 3 months, they detected astigmatic changes of 0.19 D in the blepharoplasty with fat pad reduction group and 0.25 D in the ptosis repair by levator surgery group, while no statistically significant change was detected in the astigmatic axis.…”

“… 5 Studies have also evaluated the effects of upper eyelid surgery on corneal topography. 6 , 7 , 8 , 9 , 10 , 11 …”

Evaluation of the effect of eyelid disorder surgeries on tears and anterior segment parameters with meibography and corneal topography

“…Similarly, in their study, as in the present study, Nalci et al [22] found no significant changes in K1 and K2 values in the third postoperative-month of patients who had blepharoplasty surgery relative to the pre-operative period. It is remarkable that a similar mean age was detected in the patients of both our study and the study by Nalci et al Similar to our study, the fact that the results of the blephroplasty surgery did not cause a significant change on the keratometric values can be explained by the fact that the ages of the patients who underwent surgery in our study and Nalci et al's study were similar.…”

Effect of Upper Lid Blepharoplasty Surgery on Corneal Topography and Corneal High-Order Aberrations

“…In a recently published study similar to ours, no significant difference was observed between pre-and post-operative keratometric values and astigmatism grades. 16 There are a few publications on the effect of upper eyelid diseases on corneal HOAs. A study examining the effects of chalazion excision on corneal aberrations showed a decrease in RMS total values, vertical-horizontal trefoil, and horizontal coma postoperatively.…”