Impact on Tear Film Production after Upper Lid Blepharoplasty

Abstract

Background: The global population is aging, leading to increased incidence of dermatochalasis, a condition affecting the upper eyelids due to age-related changes in levator palpebrae superioris function. Upper eyelid blepharoplasty is a common surgical intervention to correct dermatochalasis, involving excision of excess skin and fat. Despite its benefits, concerns about postoperative dry eye syndrome persist, highlighting the need for further research in this area.
Design: This prospective cohort study aimed to evaluate the impact of upper eyelid blepharoplasty on tear production and stability in patients with dermatochalasis. Ten eyes from five female patients (mean age 69.50 ± 8.26 years) were included. Tear assessments were conducted preoperatively and at 2, 6, and 12 weeks postoperatively using the Schirmer test and tear breakup time (TBUT).
Methods: Patients scheduled for upper eyelid blepharoplasty were recruited at Thammasat University Hospital. Examinations included best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure, Schirmer test, and TBUT. Exclusion criteria encompassed concurrent corneal diseases and certain pre-existing eye conditions.
Results: There were no statistically significant differences in Schirmer test measurements or TBUT between preoperative and postoperative assessments at 2, 6, and 12 weeks (p > 0.05). Mean Schirmer test values were 11.9 ± 8.99 mm preoperatively and 9.72 ± 3.55 mm at 12 weeks postoperatively. TBUT values were 9.11 ± 5.46 seconds preoperatively and 9.72 ± 3.55 seconds at 12 weeks postoperatively.
Conclusions: Upper eyelid blepharoplasty for dermatochalasis did not lead to significant changes in tear production or stability over a 12-week follow-up period. These findings suggest that careful surgical technique may preserve tear dynamics postoperatively. However, larger studies with diverse populations and longer follow-up durations are warranted to validate these results and assess potential long-term effects on ocular surface health.