Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Study to the Effect of Involutional Blepharoptosis Surgery Using Objective and Subjective Parameters

  • Asamura, Shinichi (Department of Plastic and Reconstructive Surgery, Wakayama Medical University) ;
  • Wada, Yoshitaka (Department of Plastic and Reconstructive Surgery, Wakayama Medical University) ;
  • Tanaka, Saiichi (Department of Ophthalmology, Wakayama Medical University) ;
  • Saika, Shizuya (Department of Ophthalmology, Wakayama Medical University)
  • Published : 2022.07.15
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Abstract

Background We investigate the effect of involutional blepharoptosis (IB) surgery based on dry eye symptoms by analysis using objective and subjective measures. Methods We recorded various parameters from patients that underwent levator advancement surgery for IB, totaling 125 eyes (total 65 patients, 5 unilateral, 60 bilateral). Subjective assessment comprised a questionnaire on dry eye-related quality of life score (DEQS), a summary score calculated from DEQS, and six-grade evaluation, the patient's own measure of eye comfort. Objective assessment comprised marginal-reflex distance-1 (MRD-1), measurement of tear film breakup time, and superficial keratopathy (SPK) existence by slit lamp microscope. Results Subjective assessments showed that IB patients had improvement of dry eye symptoms and eye comfort when surgery increased MRD-1. On the other hand, objective assessments showed that the presence of SPK is suspected when the postoperative MRD-1 level is 3 mm or higher. Conclusion IB surgery must not only increase MRD-1 value, but also to perform maintenance of the appropriate ocular surface condition. From our parameters, we suggest postoperative MRD-1 value should be maintained at < 3 mm to safe and effective of IB surgery.

Keywords

Acknowledgement

The authors thank Dr. Yuji Shirakawa, Dr. Shinji Kumegawa, Dr. Hideki Iwanishi, and Dr. Kazuhisa Uemura for their encouragements and assistance. The authors also acknowledge proofreading and editing by Benjamin Phillis at the Clinical Study Support Center at Wakayama Medical University.

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