Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Am J Ophthalmol. 2014 Jul;158(1):55-63.e1. doi: 10.1016/j.ajo.2014.03.016. Epub 2014 Apr 4.
To investigate the dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty.
Prospective, observational case series study.
A total of 60 eyes of 30 patients with transcutaneous lower blepharoplasty were involved in the study. All subjects completed the Ocular Surface Disease Index questionnaire and underwent tear film break-up time measurements and the Schirmer test before surgery and 1 week, 1 month, and 3 months after surgery. Tear meniscus parameters measured by optical coherence tomography were recorded. Lower lid margin reflex distance was also measured. At each time point after surgery, these parameters were compared with the baseline parameters. The incidence of dry eye and chemosis after surgery was assessed.
The Ocular Surface Disease Index score increased significantly 1 week after surgery (P < .01). The Schirmer test values were significantly decreased 1 week postoperatively (P < .01), and they returned to baseline by 3 months. There was no significant change in tear film break-up time before and after surgery. The tear meniscus height, depth, and cross section area values were significantly increased at 1 week postoperatively, decreased at 1 month (P < .01), and returned to baseline at 3 months (P > .05). The cornea-lower eyelid angle significantly decreased at 1 week postoperatively (P < .01), increased at 1 month (P < .01), and returned to baseline by 3 months (P > .05). The lower lid margin reflex distance was increased 1 week after surgery (P < .01), and gradually recovered but had not returned to the baseline 3 months after surgery (P < .01). The increased tear meniscus height had a positive correlation with lower lid margin reflex distance. The incidence of dry eye and chemosis at 1 week postoperatively was 16.7% and 15%, respectively.
Cosmetic transcutaneous lower blepharoplasty affects ocular surface and tear fluid, which leads to dryness, tearful eyes, and chemosis. However, this influence is temporary after surgery, and the symptoms resolve within 3 months. A positive correlation between tear meniscus height and lower lid margin reflex distance was observed. Assessment of the tear meniscus with optical coherence tomography provided a quick, noninvasive, and quantitative method to investigate the dynamic changes of the tear fluid after blepharoplasty.
研究美容经皮下睑成形术后泪液的动态变化。
前瞻性、观察性病例系列研究。
共纳入 30 例（60 只眼）接受经皮下睑成形术的患者。所有患者均在术前及术后 1 周、1 个月和 3 个月完成眼表疾病指数（OSDI）问卷、泪膜破裂时间（BUT）和 Schirmer 试验，并进行光学相干断层扫描（OCT）测量泪膜半月板参数。记录下睑缘反射距离（lower lid margin reflex distance，LLRD）。术后各时间点与基线参数比较，评估术后干眼和肿胀的发生率。
术后 1 周 OSDI 评分显著增加（P <.01）。术后 1 周 Schirmer 试验值显著降低（P <.01），3 个月时恢复至基线水平。手术前后 BUT 无显著变化。术后 1 周泪膜半月板高度、深度和截面积值显著增加，1 个月时降低（P <.01），3 个月时恢复至基线水平（P >.05）。术后 1 周角膜-下睑角显著减小（P <.01），1 个月时增加（P <.01），3 个月时恢复至基线水平（P >.05）。术后 1 周 LLRD 增加（P <.01），逐渐恢复，但术后 3 个月未恢复至基线水平（P <.01）。泪膜半月板高度增加与 LLRD 呈正相关。术后 1 周干眼和肿胀的发生率分别为 16.7%和 15%。
美容经皮下睑成形术影响眼表和泪液，导致眼干、流泪和肿胀。然而，术后这种影响是暂时的，症状在 3 个月内得到缓解。泪膜半月板高度与 LLRD 呈正相关。OCT 评估泪膜半月板可提供一种快速、无创、定量的方法来研究下睑成形术后泪液的动态变化。
