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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.
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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
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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.
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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
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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.
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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
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Suslavičius KA, Liutkauskaitė L, Zacharevskij E, Žuklytė R, Markevičiūtė MŠ, Pilipaitytė L. Optimizing Perioperative Experience in Upper Blepharoplasty: The Impact of Premedication on Anxiety, Pain, and Patient Satisfaction. Cureus 2024; 16:e53858. [PMID: 38465153 PMCID: PMC10924664 DOI: 10.7759/cureus.53858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background The periorbital area undergoes transformative changes with age, influencing both aesthetic appearance and functional aspects of the eyelids. Age-related alterations involve volume loss, shifts in eyelid crease position, drooping eyebrows, reduced skin elasticity, and the presence of dermatochalasis. Dermatochalasis, characterized by redundant upper eyelid skin folds, poses aesthetic and functional challenges, impacting visual acuity and eyelid elevation efficiency. Upper blepharoplasty addresses these age-related changes. Despite the elective nature of upper blepharoplasty, the procedure can evoke preoperative anxiety and discomfort. Various premedication strategies, including benzodiazepines, aim to alleviate anxiety and enhance the overall patient experience. However, ongoing debates persist regarding the optimal strategy for implementation. The study aims to contribute insights into the effectiveness of different premedication approaches in optimizing patient comfort during and after upper blepharoplasty. Methods The research design involves 182 patients divided into three groups: control group (CG) (n = 45) receiving no premedication, Group 1 (n = 98) receiving oral midazolam (a benzodiazepine), and Group 2 (n = 39) receiving a combination of midazolam, eutectic mixture of local anesthetics (EMLA) eyelid ointment, and oral paracetamol with codeine phosphate hemihydrate. The study assesses anxiety levels, pain perception during local anesthetic injection, surgery, and postoperatively, as well as the use of painkillers and adverse effects. Ethical approval was obtained for the study. Results Significant differences were noted among the groups during local anesthetic injection (p < 0.0001), surgery (p < 0.0001), and post surgery (p < 0.0197). CG patients experienced higher pain levels during local anesthetic injection and surgery compared to Groups 1 and 2. Group 1 reported more pain during surgery than Group 2. Substantial differences were observed in preoperative (p < 0.0001), during-surgery (p < 0.0001), and after-surgery (p < 0.0001) anxiety levels. The CG exhibited higher preoperative anxiety compared to Group 1, while Group 1 had lower anxiety during surgery compared to the CG. Group 1 also reported lower anxiety after surgery than both the CG and Group 2. A significant difference was found in post-surgery painkiller usage among the groups (p = 0.0003). Group 2 showed significantly lower usage compared to Group 1 (p = 0.0004) and the CG (p = 0.0006). A significant difference was observed in the duration of painkiller use after surgery (p < 0.0014). The CG had a longer duration than Group 1 (p = 0.0049) and Group 2 (p = 0.0495). Conclusions Midazolam alone as premedication effectively reduced anxiety before, during, and after surgery. EMLA administration for injection pain did not produce superior results, likely due to its delayed onset. Paracetamol with codeine phosphate hemihydrate effectively reduced surgical pain and postoperative pain duration and decreased the need for painkillers.
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Affiliation(s)
| | - Laura Liutkauskaitė
- Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Ernest Zacharevskij
- Department of Plastic and Reconstructive Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Rūta Žuklytė
- Department of Eye Diseases, Republican Vilnius University Hospital, Vilnius, LTU
| | - Medeinė Š Markevičiūtė
- Department of Plastic and Reconstructive Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Loreta Pilipaitytė
- Department of Plastic and Reconstructive Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
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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.
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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
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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 .
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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
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Ulas MG, Tukenmez Dikmen N. Effect of Upper Lid Blepharoplasty Surgery on Corneal Topography and Corneal High-Order Aberrations. Facial Plast Surg 2023; 39:581-585. [PMID: 36878679 DOI: 10.1055/a-2047-7405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
The objective of this study was to prospectively investigate the effect of upper eyelid blepharoplasty surgery for dermatochalasis on corneal topographic data and high-order aberrations (HOAs). Fifty eyelids of 50 patients with dermatochalasis who underwent upper lid blepharoplasty surgery were prospectively studied. A Pentacam (Scheimpflug camera, Oculus) device was used to measure corneal topographic values, astigmatism degree, and HOAs before and at 2 months after upper eyelid blepharoplasty. The mean age of the patients included in the study was 55.96 ± 12.4 years, 40 (80%) were female and 10 (20%) were male. We found no statistically significant difference in the pre-and postoperative values of corneal topographic parameters (p > 0.05 for all). In addition, we observed no significant postoperative change in the root mean square values of low, high, and total aberration values. In HOAs, we detected no significant change in spherical aberration, horizontal and vertical coma, and vertical trefoil; we only found a statistically significant increase in horizontal trefoil values after surgery (p < 0.05). In our study, we found that upper eyelid blepharoplasty did not cause significant changes in corneal topography, astigmatism, and ocular HOAs. However, studies are reporting different results in the literature. For this reason, it is important for patients considering upper eyelid surgery to be warned about visual changes that may occur after surgery.
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Affiliation(s)
- Mehmet Goksel Ulas
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Türkiye
| | - Nejla Tukenmez Dikmen
- Department of Ophthalmology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Türkiye
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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 .
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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
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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.
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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.
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Evereklioglu C, Sener H, Horozoglu F. Top 50 Most-Cited Publications on Blepharoplasty Surgery Between 2015 and 2022: From a Current Altmetric Perspective of Research Impact. Indian J Plast Surg 2023; 56:118-123. [PMID: 37153349 PMCID: PMC10159707 DOI: 10.1055/s-0043-1761178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Abstract
Background Blepharoplasty is one of the most-performed esthetic operations, and social media platforms have become an influential tool for distributing scientific information. Because the internet has gained popularity among medical experts and surgeons to connect with the public, we aimed to evaluate the altmetric–bibliometric analysis of the top 50 most-cited articles on blepharoplasty surgery between 2015 and 2022 and assess correlations with various metrics.
Methods “Blepharoplasty” was searched using the WoS database, and the altmetric score was obtained. Co-authors, keywords, country of authors, and cited journal network map analysis were created using VOSviewer for the 485 publications retrieved. The articles' focus was examined quantitatively and the most prolific parameters were identified.
Results The most research was performed by the USA, the most productive institution was the “University of California System,” and the most prolific author was “Wonn CH.” The number of citations ranged from 37 to 9, and altmetric attention scores ranged from 54 to 0. The most articles and citations peaked in 2021. Altmetric and Twitter scores were moderately correlated with journal metrics but there were no correlations with citation counts.
Conclusion The first comprehensive altmetric analysis on blepharoplasty surgery offers new guidelines for upcoming articles by demonstrating the recent investigation trends, prolific parameters, and zones with potential for the public's attention and education, providing valuable data regarding the distribution of scientific knowledge in social media platforms and to the general public. A social network may be used to increase the visibility of scientific articles apart from creating brands and markets.
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Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Division of Oculoplastic, Orbital, and Lacrimal Surgery, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hidayet Sener
- Department of Ophthalmology, Division of Oculoplastic, Orbital, and Lacrimal Surgery, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Fatih Horozoglu
- Department of Ophthalmology, Division of Oculoplastic, Orbital, and Lacrimal Surgery, Erciyes University Medical Faculty, Kayseri, Turkey
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11
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Ilhan C, Aydemir GA, Aydemir E. Changes in Intraocular Pressure and Ocular Biometry After Blepharoplasty. Aesthetic Plast Surg 2022; 46:2295-2300. [PMID: 35018494 DOI: 10.1007/s00266-021-02756-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/25/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate the effects of blepharoplasty on intraocular pressure (IOP) and ocular biometric parameters. METHODS A total of 112 eyelids of 56 patients undergoing bilateral blepharoplasty due to upper eyelid dermatochalasis was included. The patients were classified into three groups according to margin reflex distance (MRD) (Group 1 >4 mm MRD, Group 2 2-4 mm MRD, and Group 3 <2 mm MRD). The IOP and ocular biometric parameters obtained baseline and postoperative 3rd month were compared. RESULTS The demographic characteristics of the groups were similar (p > 0.05, for all). IOP (p = 0.002) and central corneal thickness (p = 0.038) increased in Group 3. The mean amount of the increase in IOP was 0.95mmHg. The keratometric values increased in all groups and corneal astigmatism was also increased in Group 2 and Group 3 (p < 0.001, for all). The mean amount of the increase in corneal astigmatism was 0.54D in Group 3. Anterior chamber depth and axial length did not change (p > 0.05, for all). The intraocular lens powers calculated by six different formulas decreased in Group 3 (p < 0.001, for all), and the mean amount of the decrease was 0.40D. CONCLUSIONS Clinicians should be aware of the potential change in IOP and ocular biometric parameters in patients who underwent blepharoplasty. If a patient has glaucoma risk factors, close follow-up is needed after blepharoplasty. Change in strategy or timing may also be needed for dermatochalasis patients when planning corneal refractive surgery or cataract surgery. 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 .
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Affiliation(s)
- Cagri Ilhan
- Department of Ophthalmology, Hatay Education and Research Hospital, Ekinci Mah. Cevreyolu Cad. Royals Park 13/1 No:23, Antakya, Hatay, Turkey.
| | - Gozde Aksoy Aydemir
- Department of Ophthalmology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Emre Aydemir
- Department of Ophthalmology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
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Effect of upper eyelid blepharoplasty on corneal biomechanical, topographic and tomographic parameters 4 weeks after surgery. Int Ophthalmol 2021; 42:113-121. [PMID: 34478004 PMCID: PMC8803703 DOI: 10.1007/s10792-021-02006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/07/2021] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the effect of “skin-only” upper eyelid blepharoplasty on corneal biomechanics and central as well as peripheral topographic/tomographic parameters before and 4 weeks after surgery. Methods In a prospective study, the corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated before and after blepharoplasty. Corneal topographic (maximum simulated keratometry value, inferior-superior value, index of surface variance, index of vertical asymmetry, index of height asymmetry, index of height decentration) and tomographic parameters (corneal thickness, corneal astigmatism and mean 5-mm- and 7-mm-zone keratometry value) were measured by the Pentacam HR. Statistical analysis was performed using a linear mixed model considering correlated data of both eyes. Results This study included 42 eyes of 35 patients (mean age: 64.5 years, range 52–82 years). Four weeks after surgery CH and CRF increased (9.4 ± 2.3 to 10.2 ± 2.2 mmHg and 9.7 ± 2.1 to 10.5 ± 2.2 mmHg) but did not reach statistical significance (P = 0.100 and P = 0.072). A significant increase in central maximum simulated keratometry value (Kmax) from 45.0 ± 2.3 to 45.4 ± 2.2 diopters (D) was observed (P = 0.004). Inferior-superior value (I-S) and index of surface variance (ISV) showed significant changes from 0.32 ± 0.98 to 0.10 ± 0.98 D (P = 0.02) and from 19.98 ± 9.84 to 22.93 ± 11.23 (P = 0.009), respectively. These alterations did not affect the subjective spherical equivalent (-0.09 ± 4.71 to -0.04 ± 4.51 D; P = 0.437) and the best-corrected distance visual acuity of patients (0.11 ± 0.14 to 0.15 ± 0.15 logMAR; P = 0.142). Age, gender and corneal thickness were not correlated with pre and postoperative differences of CH, CRF, corneal compensated IOP, Kmax, corneal astigmatism or I-S. Conclusion The trend of increasing CH and CRF values might indicate a rise of corneal damping capacity. Despite statistically significant differences of Kmax, I-S and ISV, all other tomographical and topographical parameters did not change 4 weeks after surgery. The corneal steepening with a mean change of 0.4 diopters and the decrease of I-S with a mean of 0.22 diopters do not seem to have a clinically relevant effect for blepharoplasty patients in daily practice.
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Mehlan J, Jonca B, Dulz S, Green S, Spitzer MS, Schüttauf F. [Comparative analysis of refractive and topographic changes after eyelid surgery]. Ophthalmologe 2021; 119:3-10. [PMID: 33738582 PMCID: PMC8763770 DOI: 10.1007/s00347-021-01361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/25/2021] [Accepted: 02/22/2021] [Indexed: 11/20/2022]
Abstract
Hintergrund und Ziel der Arbeit Über die Frage, ob nach Blepharoplastik, Levatorresektion oder lateraler Zügelplastik Refraktions- oder Topographieveränderungen zu erwarten sind, besteht weitestgehend Unklarheit. Material und Methoden Daher wurden in der vorliegenden Studie prä- sowie postoperativ von 78 Patienten objektive Refraktion, Vorderabschnittstomographie mittels Pentacam und Visusprüfung durchgeführt und der Analyse zugeführt. Die Untersuchung erfolgte präoperativ, zum Zeitpunkt des Fadenzugs nach 10 Tagen sowie nach 3 Monaten. Ergebnisse Wir fanden postoperativ weder nach Blepharoplastik noch nach lateraler Zügelplastik signifikante Veränderungen von Visus oder Refraktion noch in der Topographie. Hingegen zeigt der Wilcoxon-Vorzeichen Test 10 Tage nach der Levatorresektion einen signifikanten Anstieg des Zylinders nach 10 Tagen im Vergleich zum präoperativen Niveau (p = 0,042). Diese Veränderung war jedoch nach 3 Monaten nicht mehr nachweisbar. Schlussfolgerung Wir postulieren daher, dass eine umfangreiche Aufklärung von Patienten hinsichtlich passagerer Sehveränderungen insbesondere bei Levatorresektionen unabdingbar ist und postoperativ eine ergänzende Refraktions- und Topographiekontrolle sinnvoll sein kann.
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Affiliation(s)
- J Mehlan
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - B Jonca
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - S Dulz
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - S Green
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - M S Spitzer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - F Schüttauf
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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Bhattacharjee K, Misra D, Singh M, Deori N. Long-term changes in contrast-sensitivity, corneal topography and higher-order aberrations after upper eyelid blepharoplasty: A prospective interventional study. Indian J Ophthalmol 2020; 68:2906-2910. [PMID: 33229668 PMCID: PMC7856954 DOI: 10.4103/ijo.ijo_907_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The aim of this study was to analyze the long-term changes in visual parameters, that is, contrast sensitivity (CS) and higher-order aberrations (HOAs), and corneal topography in the patients undergoing upper eyelid blepharoplasty (UEB) for dermatochalasis. Methods This was a prospective, single surgeon, intervention study including patients (≥40 years age) having severe dermatochalasis with a minimum post-UEB follow-up of 12 months. The preoperative readings of CS (using Pelli-Robson chart), HOAs (using WaveLight ALLEGRO analyzer), and corneal topography (using topographic modeling system-4, Tomey corporation) were noted and compared at 3, 6, and 12 postoperative months. Results We studied 30 patients (60 eyes) who underwent bilateral UEB. The majority of patients were females (n = 21,70%), and the mean age of patients was 56.53 ± 9.06 years. The preoperative and postoperative values of LogMAR visual acuity, log CS value, corneal topography measurements (K1, K2, cylinder value, and the axis), optical aberrations (total HOAs; third-order--trefoil & coma; four-order--spherical aberrations and secondary astigmatism, and tetrafoil) were compared. At 12 months, the mean CS value, the majority of HOAs, and corneal topography (only cylinder values) showed a stable, statistically significant difference in the postoperative period. Conclusion The UEB may produce long-term, visually-beneficial, optical, and corneal changes. The patients undergoing cataract surgery aiming for spectacle independence may gain additional visual benefits with UEB.
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Affiliation(s)
- Kasturi Bhattacharjee
- Department of Orbit, Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Beltola, Guwahati, Assam, India
| | - Divakant Misra
- Department of Orbit, Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Beltola, Guwahati, Assam, India
| | - Manpreet Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Insitute of Medical Education and Research, Chandigarh, India
| | - Nilutparna Deori
- Department of Orbit, Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Beltola, Guwahati, Assam, India
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Nalcı H, Hoşal MB, Gündüz ÖU. Effects of Upper Eyelid Blepharoplasty on Contrast Sensitivity in Dermatochalasis Patients. Turk J Ophthalmol 2020; 50:151-155. [PMID: 32631001 PMCID: PMC7338742 DOI: 10.4274/tjo.galenos.2019.95871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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.
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Affiliation(s)
- Hilal Nalcı
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Melek Banu Hoşal
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Ömür Uçakhan Gündüz
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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Zloto O, Matani A, Sagiv O, Prat D, Ben Artsi E, Leshno A, Priel A, Ben Simon GJ. Changes in Refraction and Visual Acuity after Upper Eyelid Blepharoplasty versus Posterior Approach Ptosis Procedures. Ophthalmic Res 2020; 63:588-592. [PMID: 32135543 DOI: 10.1159/000506951] [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: 11/06/2019] [Accepted: 03/02/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate surgically induced refractive changes (SIRC) and visual acuity (VA) changes after blepharoplasty combined with posterior approach ptosis surgery (Müller's muscle-conjunctival resection [MMCR]) versus upper eyelid blepharoplasty alone. METHODS In this prospective, comparative, clinical study on patients undergoing MMCR and blepharoplasty, comprehensive ophthalmic examinations were performed preoperatively and 3 months postoperatively. SIRC were calculated with the 10-step Holladay method. RESULTS Fifty-six patients participated in the study, 31 in the blepharoplasty group and 25 in the ptosis group. logMAR VA improved significantly after surgery in both groups (p < 0.001). In both groups, most patients showed significant changes in SIRC sphere and spherical equivalent of >0.5 D (blepharoplasty group: 61.29 and 67.74%; ptosis group: 72.72 and 72.72%, respectively). Patients undergoing combined blepharoplasty ptosis surgery showed the greatest SIRC cylinder. CONCLUSIONS Upper eyelid blepharoplasty with or without MMCR is associated with significant SIRC 3 months postoperatively. This may affect decision-making for all patients, especially for those who intend to seek refractive correction in addition to the index upper eyelid surgery.
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Affiliation(s)
- Ofira Zloto
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Adham Matani
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Oded Sagiv
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Daphna Prat
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Elad Ben Artsi
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Ari Leshno
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Ayelet Priel
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Guy J Ben Simon
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel,
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