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

OBJECTIVES: To evaluate the effect of upper eyelid surgery on ocular surface and corneal topography. MATERIALS AND METHODS: Patients who underwent upper eyelid blepharoplasty and/or blepharoptosis repair were evaluated prospectively. Tear film break-up time (TBUT), Schirmer tests, corneal staining pattern, Ocular Surface Disease Index questionnaire, corneal topography, and autorefractor parameters were measured preoperatively and at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. RESULTS: Thirty-two eyes of 20 patients (9 male, 11 female) were included in the study. The mean age was 44.8±18.9 years (range: 8-74). Patients were divided into the following 3 groups according to the type of surgery performed: upper eyelid blepharoplasty (group 1), upper eyelid blepharoplasty and levator advancement ptosis surgery (group 2), and levator advancement ptosis surgery (group 3). There was a significant decrease in Schirmer test results at 6 months in groups 1 and 2 but no change in group 3. TBUT values were decreased at 1 week in group 3 (p=0.028) and returned to baseline at 1 month. Corneal punctate staining was detected at 1 day and 1 week in all groups. On corneal topography, group 3 showed a significant change in K2 values (0.3 diopters) at 1 month (p=0.006). There was no statistically significant change in autorefractor measurements postoperatively compared to preoperative values (p>0.05). CONCLUSION: Depending on the type of surgical procedure performed, blepharoptosis repair and upper eyelid blepharoplasty can lead to dry eye of varying severity that may persist at postoperative 6 months.