1
|
Francisco ZM, Carlos RDL, Santiago OP, Rahul RA, Jose-Luis TC, Joaquín F. Refractive changes associated with oculoplastic surgeries: A scoping review. Eur J Ophthalmol 2024:11206721241247422. [PMID: 38623746 DOI: 10.1177/11206721241247422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE To carry out a comprehensive critical review of the peer-reviewed literature on the refractive changes associated with oculoplastic surgeries. METHODS This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) statement recommendations. Following specific inclusion and exclusion criteria, 20 articles were selected for the current scoping review. Each of them was analyzed carefully and their risk of bias was assessed with the Quality Assessment Tool for case Series Studies from the National Heart, Lung and Blood Institute. RESULTS Data of 1428 eyes from 1051 patients were analyzed. All studies were case series. Regarding the oculoplastic pathologies, five articles focused on dermatochalasis, four on chalazion, five on ptosis and six on congenital ptosis. Most articles did not report changes in the spherical equivalent (SE), astigmatism changes of less than 0.5 diopters (D), changes in astigmatism axis of less than 11 degrees and changes in uncorrected distance visual acuity (UDVA) of less than 0.06 logMAR. Out of the 20 articles reviewed, 6 achieved a risk of bias score between 6 and 8, representing a low level of evidence and highlighting the limitations in the study design. CONCLUSIONS Based on the findings of this study, there is no evidence to suggest clinically significant refractive changes following oculoplastic surgeries. The most notable changes may occur after surgery for severe ptosis; however, further research is needed to confirm this observation.
Collapse
Affiliation(s)
- Zamorano-Martín Francisco
- Oculoplastic Surgery Department, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Ciudad de México, México
- Deparment of Ophthalmology, Faculty of medicine, Universidad de Málaga, Málaga, Spain
- Qvision, Opththalmology Department, VITHAS Almería Hospital, Almería, Spain
| | - Rocha-de-Lossada Carlos
- Qvision, Opththalmology Department, VITHAS Almería Hospital, Almería, Spain
- Ophthalmology Department, VITHAS Málaga, Málaga, Spain
- Hospital Regional Universitario Málaga, Málaga, Spain
- Departamento de Cirugía, Universidad de Sevilla, Sevilla, Spain
| | - Ortiz-Pérez Santiago
- Qvision, Opththalmology Department, VITHAS Almería Hospital, Almería, Spain
- Unidad de Gestión Clínica de Oftalmología, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Departamento de Cirugía y sus Especialidades, Universidad de Granada, Granada, Spain
- Granada Vision and Eye Research Team (VER), Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | - Rachwani-Anil Rahul
- Hospital Norte de Málaga (Antequera), Málaga, Spain
- Ophthalmology Department, Centro Médico San Juan de la Cruz, Málaga, Spain
| | - Tovilla-Canales Jose-Luis
- Director of the Oculoplastic Surgery Department, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Ciudad de México, México
| | - Fernández Joaquín
- Qvision, Opththalmology Department, VITHAS Almería Hospital, Almería, Spain
| |
Collapse
|
2
|
Ulas B, Ozcan A, Yar K, Kaya I, Binokay H. Evaluation of visual field and ocular surface parameters by clinical comparison after blepharoplasty for dermatochalasis. J Fr Ophtalmol 2024; 47:104135. [PMID: 38447291 DOI: 10.1016/j.jfo.2024.104135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/03/2023] [Accepted: 09/22/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE To evaluate the effect of upper eyelid blepharoplasty surgery on corneal topography, visual field, ocular surface, meibography, corneal biomechanics and dry eye parameters. METHODS This prospective study included a total 80 eyes of 40 patients. Following a detailed ophthalmological examination, standardized patient satisfaction questions were posed to patients before and after upper eyelid blepharoplasty surgery. Visual field test, non-invasive break up time (NIBUT), meibography, and corneal topography parameters were analyzed and evaluated. RESULTS The mean (+) visible areas in the visual field were found to be 46.20±24.96 preoperatively, 56.73±21.98 at the 1st postoperative month and 65.96±18.5 at the 3rd month, which were statistically significant. NIBUT values preoperatively, at 1 month and at 3 months were 11.26±4.48, 11.16±4.5 and 10.14±4.0, respectively, which were statistically significant. Meibomian gland loss rates on meibography preoperatively and postoperatively at 1 and 3 months were found to be 30.24±8.3, 29.36±8.2 and 28.22±7.7 respectively and were statistically significant. With the scoring system after blepharoplasty, patients reported improvement in their symptoms. CONCLUSION Upper eyelid blepharoplasty surgery is predicted to increase the quality of vision. It was observed that there was a functional and cosmetic improvement in the complaints of the patients after blepharoplasty. However, blepharoplasty may cause changes in eyelid dynamics and cause dry eye syndrome.
Collapse
Affiliation(s)
- B Ulas
- Cukurova University Faculty of Medicine Ophthalmology Department, Adana, Turkey.
| | - A Ozcan
- Cukurova University Faculty of Medicine Ophthalmology Department, Adana, Turkey
| | - K Yar
- Cukurova University Faculty of Medicine Ophthalmology Department, Adana, Turkey
| | - I Kaya
- Cukurova University Faculty of Medicine Ophthalmology Department, Adana, Turkey
| | - H Binokay
- Cukurova University Faculty of Medicine Biostatistics Department, Adana, Turkey
| |
Collapse
|
3
|
Koc H, Ozen S, Bayram U, Kanik A. Evaluation of early period changes in intraocular pressure, ocular biometry and anterior segment after upper eyelid blepharoplasty. Int Ophthalmol 2024; 44:2. [PMID: 38315421 DOI: 10.1007/s10792-024-02935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE To investigate the acute effects of upper eyelid blepharoplasty on intraocular pressure (IOP) and ocular biometric parameters. METHOD This prospective cross sectional study examined the eyes of 49 patients with dermatochalasis. Following a detailed ophthalmological examination, corneal topography was used to evaluate the eyes mesopic and photopic pupil diameter, anterior chamber depth, and corneal astigmatism on the day of surgery and on days first and seventh postoperatively. Ocular biometry was used to assess axial length and intraocular lens power. Goldmann applanation tonometry was used to measure intraocular pressure. RESULTS Forty-nine eyes (26 males and 23 females) of 49 patients aged between 44 and 76 years (mean 61 ± 7.9) were included in our study. The mean anterior chamber depth (ACD) was 2.90 ± 0.37 mm preoperatively, 3.00 ± 0.29 mm at postoperative day first, and 3.04 ± 0.29 mm at postoperative day seventh, and the increase in anterior chamber depth was statistically significant (p < 0.001). The mean astigmatism values were measured as preoperative 0.73 ± 0.69 D, postoperative first day 0.93 ± 0.81 D, and postoperative seventh day 1.26 ± 0.90 D. The increase in astigmatism values was statistically significant (p < 0.001). The mean pupil diameter measurements in the mesopic environment were 4.20 ± 0.61 mm preoperatively, 4.40 ± 0.59 mm on the first postoperative day, and 4.39 ± 0.57 mm on the seventh postoperative day, and there was a statistically significant difference between the three measurements (p = 0.03). The mean IOP measurements of the patients were 15.91 ± 3.51 mmHg preoperatively, 16.81 ± 3.36 mmHg on the first postoperative day, and 16.97 ± 3.13 mmHg on the seventh postoperative day. The increase between these three measurements was statistically significant (p = 0.013). CONCLUSION This study includes important insights into the potential acute phase impact of blepharoplasty surgery on ocular findings. Patients undergoing upper eyelid surgery should be informed about the possible change in ocular biometric parameters, intraocular pressure, and pupil diameter.
Collapse
Affiliation(s)
- Hakan Koc
- Department of Ophthalmology, Faculty of Medicine, Giresun University, Giresun, Turkey.
| | - Serkan Ozen
- Department of Ophthalmology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Ugur Bayram
- Department of Ophthalmology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Ali Kanik
- Department of Ophthalmology, Faculty of Medicine, Giresun University, Giresun, Turkey
| |
Collapse
|
4
|
Carreira P, Loureiro T, Carreira AR, Gouveia-Moraes F, Cardoso A, Sampaio A, Campos P, Rodrigues-Barros S, Machado I, Campos N. The Effect of Upper Eyelid Blepharoplasty on Corneal Tomography and Epithelial Profile. Clin Ophthalmol 2023; 17:3801-3807. [PMID: 38105910 PMCID: PMC10725641 DOI: 10.2147/opth.s426034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Upper tarsal mechanical forces influence corneal epithelial thickness profile, which could modulate corneal astigmatism. Upper eyelid blepharoplasty reduces upper tarsal strength and may have an impact on ocular surface. The aim of this study is to evaluate the effect of upper eyelid blepharoplasty on corneal epithelial thickness profile, astigmatism and aberrations. Methods Patients with dermatochalasis underwent bilateral upper eyelid blepharoplasty. Anterior segment optical coherence tomography (AS-OCT) (Zeiss Cirrus 5000 HD-OCT) and Pentacam (Oculus, Wetzlar Germany) were performed before surgery and in the 8th postoperative week. Corneal epithelial thickness, keratometry, aberrations and asphericity were considered for statistical purposes. Only right eyes were considered. A p-value lower than 0.05 was considered significant. Results Thirty eyes of 30 patients were included. The degree of astigmatism did not change after surgery (0.95D vs 0.83D, p=0.23). The difference between preoperative and postoperative steepest axis was 3.1° (p=0.04) with a tendency to change toward the vertical meridian. Mean epithelial thickness was higher in the inferior region both pre- and postoperatively and did not change. ET in the superior octant was lower (42 µm vs 45 µm, p<0.01) and the difference between inferior and superior octants (I-S) was higher (7 µm vs 3 µm, p<0.001) before surgery. There were no statistically significant changes in corneal aberrations (p=0.52) and asphericity (p=0.41) after surgery. Conclusion Our results support that upper tarsus pressure influences epithelial thickness profile and, consequently, the corneal steepest keratometry. These results lead us to postulate that upper eyelid blepharoplasty may influence biometric and keratometric measurements.
Collapse
Affiliation(s)
- Pedro Carreira
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Tomás Loureiro
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Rita Carreira
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Filipe Gouveia-Moraes
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Cardoso
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Audrey Sampaio
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Paul Campos
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Sandra Rodrigues-Barros
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ines Machado
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Nuno Campos
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| |
Collapse
|
5
|
Acar Eser N, Serbest Ceylanoglu K, Sen E. Influence of Upper Eyelid Surgeries on Corneal Morphology Detected with Pentacam. Aesthetic Plast Surg 2023; 47:2432-2439. [PMID: 37097452 DOI: 10.1007/s00266-023-03366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/08/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE To analyze the corneal morphological parameters before and one month after the upper eyelid (UE) blepharoplasty and external levator resection (ELR) for ptosis surgery. MATERIALS AND METHODS Seventy eyes of 70 patients with dermatochalasis (50 eyes) and acquired aponeurotic ptosis (AAP) (20 eyes) included in this prospective study. Detailed ophthalmologic examination was performed including the best corrected visual acuity (BCVA), slit lamp examination and dilated fundoscopy. Measurements were made before and one month after the surgeries using Pentacam. Central corneal thickness (CCT), pupil center pachymetry (PCP) and thinnest pachymetry (TP), cornea front astigmatism (AST), flat keratometry (K1), steep keratometry (K2) and mean keratometry (Km) values were evaluated. RESULTS Higher postoperative Km measurements were observed in dermatochalasis (p = 0.038) patients. Postoperative AST values were significantly lower in both dermatochalasis and ptosis cases (p = 0.034, p = 0.003, respectively). Increased PCP and TP were found in the AAP patients (p = 0.014, p = 0.015, respectively). DISCUSSION UE blepharoplasty and ELR surgeries both lead to some significant changes on corneal structure post-operatively. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Nazan Acar Eser
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Altındağ, 06250, Ankara, Turkey.
| | - Kubra Serbest Ceylanoglu
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Altındağ, 06250, Ankara, Turkey
| | - Emine Sen
- Ankara Etlik City Hospital, Ankara, Turkey
| |
Collapse
|
6
|
Rodrigues C, Carvalho F, Marques M. Upper Eyelid Blepharoplasty: Surgical Techniques and Results-Systematic Review and Meta-analysis. Aesthetic Plast Surg 2023; 47:1870-1883. [PMID: 37430010 PMCID: PMC10581926 DOI: 10.1007/s00266-023-03436-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/28/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Upper eyelid blepharoplasty is a surgical procedure that aims to correct the typical changes that occur with aging to the periorbital area. The outcomes of this surgery are aesthetic, as well as functional. Many studies have described an impact on the cornea, intraocular pressure, dry eye syndrome, and visual quality. The aim of this systematic review is to compare the different surgical techniques and their outcomes. METHODS The authors performed a literature review through online databases PubMed, Web of Science, Clinicaltrials.gov, and CENTRAL libraries. Information was collected about the surgery techniques and the functional and aesthetic outcomes as well as complications of the interventions. Six types of upper blepharoplasty surgery were studied. Data were analyzed using Cochrane RevMan. RESULTS Twenty studies were included in our systematic review and nine in our meta-analysis. We presented results about intraocular pressure, central corneal thickness, flattest keratometry, steepest keratometry, corneal astigmatism, visual acuity, Schirmer test 1 and 2, tear film break-up time and the ocular surface disease index questionnaire, according to type of surgery. Our meta-analysis showed no significant results. CONCLUSIONS No significant results were found; however, many studies reported an impact of upper blepharoplasty surgery in the outcomes studied. Only a small number of complications were reported, and patients were satisfied with the aesthetic outcomes. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .
Collapse
Affiliation(s)
- Catarina Rodrigues
- Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Francisco Carvalho
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar de São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marisa Marques
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
7
|
Heidari M, Haydar AA, Rajabi MT, Rafizadeh SM. Corneal biophysical changes after upper eyelid blepharoplasty and ptosis surgery: a review. BMC Ophthalmol 2023; 23:253. [PMID: 37280563 DOI: 10.1186/s12886-023-03010-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
Upper eyelid surgeries, such as blepharoplasty and ptosis correction, are commonly performed procedures worldwide. This review examines the effects of these surgeries on ocular properties and visual function. A search of the PubMed and Google Scholar databases was conducted to identify relevant articles published after 2000. The results demonstrate that the ocular and adnexal organs function as a unified visual system, with changes in one component affecting the functions of others. Eyelid surgery can alter ocular properties and functions by modifying retinal lighting and ocular optics. These alterations can affect intraocular pressure estimation, corneal curvature, corneal epithelial thickness, refractive power of the cornea, and intraocular lens calculation. Additionally, eyelid surgery can exacerbate dry eye symptoms and impact contrast sensitivity, which is a significant factor in visual quality. Therefore, understanding these interactions is crucial before performing eyelid surgery and during follow-up. This review summarizes recent literature on the effects of upper eyelid surgery on corneal properties and visual function, emphasizing the importance of considering these factors when planning or undergoing such procedures.
Collapse
Affiliation(s)
- Mostafa Heidari
- Farabi Eye Research Center, Department of Oculofacial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran
| | - Ali A Haydar
- Farabi Eye Research Center, Department of Oculofacial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran
| | - Mohammad Taher Rajabi
- Farabi Eye Research Center, Department of Oculofacial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran
| | - Seyed Mohsen Rafizadeh
- Farabi Eye Research Center, Department of Oculofacial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran.
| |
Collapse
|