Long-term changes in contrast-sensitivity, corneal topography and higher-order aberrations after upper eyelid blepharoplasty: A prospective interventional study

Kasturi Bhattacharjee, Divakant Misra, Manpreet Singh, Nilutparna Deori, Kasturi Bhattacharjee, Divakant Misra, Manpreet Singh, Nilutparna Deori

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.

Keywords: Contrast sensitivity; corneal topography; optical aberrations; upper eyelid blepharoplasty.

Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) A 62-year-female showing grade -3 dermatochalasis with significant lateral hooding. (b) The upper eyelid skin marking showing a lateral 'W' shaped configuration for additional 'lift' for the lateral hooding. The marking is done in the pre-operative room with the patient in an upright position. (c and d) A close-up of the right and left upper eyelids after the 'W' shaped marking before the bilateral simultaneous UEB surgery
Figure 2
Figure 2
The pre- (a) and postoperative (b) photograph of a 60-year-female who underwent UEB. The color graphs of corneal topography, pre-(c) and postoperative (d), show a change in the cylinder values
Figure 3
Figure 3
The pre- (a) and postoperative (b) photograph of a 55-year-female. The color-graph of pre-(c) and postoperative (d) wavefront aberrometry showing a change in the HOAs and wavefront refraction
Figure 4
Figure 4
The graph plots depicting the pre- and postoperative (6 months) HOAs at 4 mm pupil. (a) Trefoil, (b) Coma, (c) Tetrafoil, (d) Secondary astigmatism, (e) Spherical aberration (f) Corneal topography

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Source: PubMed

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