Altin Ekin Meryem, Karadeniz Ugurlu Seyda
Department of Ophthalmology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Eur J Ophthalmol. 2020 Sep;30(5):978-984. doi: 10.1177/1120672119857501. Epub 2019 Jun 17.
OBJECTIVE: To evaluate the changes of visual acuity, contrast sensitivity, astigmatism, and higher order aberrations after blepharoplasty in patients with dermatochalasis. METHODS: Two hundred six eyelids of 103 patients with dermatochalasis were prospectively studied. Visual acuity, contrast sensitivity, corneal topography, astigmatism degree, and higher order aberrations were examined and recorded before and at 1 month after upper eyelid blepharoplasty. Change in contrast sensitivity and astigmatism values were determined according to margin reflex distance of patients, which were classified into three following groups: <2 mm, 2-3 mm, and ⩾ 4 mm. A Wilcoxon signed rank test was performed to compare the difference. RESULTS: No significant differences were observed for visual acuity (p = 0.157). The contrast sensitivity of patients significantly increased at all spatial frequencies both under glare and nonglare conditions (p < 0.05). The mean refractive astigmatism significantly decreased from ‒1.01 ± 1.3 to ‒0.79 ± 0.71, postoperatively (p = 0.029). In patients with marginal reflex distance < 2 mm, mean contrast sensitivity was increased (p < 0.001) and mean astigmatism was decreased significantly (p < 0.001) compared with those with ⩾ 2 mm. Higher order aberrations decreased significantly from 0.62 ± 0.41 µm to 0.55 ± 0.38 µm (p = 0.038) after blepharoplasty. Root mean square of the vertical trefoil (p = 0.038), vertical coma (p = 0.002), horizontal trefoil (p = 0.027), third-order aberration (p = 0.005), secondary vertical stigmatism (p = 0.001), spherical aberration (p = 0.023), secondary horizontal astigmatism (p = 0.002), fourth-order aberration (p = 0.024), vertical pentafoil (p = 0.015), secondary horizontal coma (p = 0.035), secondary horizontal trefoil (p = 0.030), and horizontal pentafoil (p = 0.048) were decreased significantly. CONCLUSION: Upper eyelid blepharoplasty in patients with dermatochalasis has a significant improvement in visual function in terms of contrast sensitivity, astigmatism, and higher order aberrations.
目的：评估睑皮肤松弛症患者行眼睑成形术后视力、对比敏感度、散光及高阶像差的变化。 方法：对103例睑皮肤松弛症患者的206只眼睑进行前瞻性研究。在上睑眼睑成形术前及术后1个月检查并记录视力、对比敏感度、角膜地形图、散光度数及高阶像差。根据患者的边缘反射距离确定对比敏感度和散光值的变化，将患者分为以下三组：<2 mm、2 - 3 mm和⩾4 mm。采用Wilcoxon符号秩检验比较差异。 结果：视力无显著差异（p = 0.157）。在眩光和非眩光条件下，患者的对比敏感度在所有空间频率均显著提高（p < 0.05）。术后平均屈光性散光从−1.01±1.3显著降低至−0.79±0.71（p = 0.029）。与边缘反射距离⩾2 mm的患者相比，边缘反射距离<2 mm的患者平均对比敏感度增加（p < 0.001），平均散光显著降低（p < 0.001）。眼睑成形术后高阶像差从0.62±0.41 µm显著降低至0.55±0.38 µm（p = 0.038）。垂直三叶像差（p = 0.038）、垂直彗差（p = 0.002）、水平三叶像差（p = 0.027）、三阶像差（p = 0.005）、二级垂直像散（p = 0.001）、球差（p = 0.023）、二级水平像散（p = 0.002）、四阶像差（p = 0.024）、垂直五叶像差（p = 0.015）、二级水平彗差（p = 0.035）、二级水平三叶像差（p = 0.030）和水平五叶像差（p = 0.048）均显著降低。 结论：睑皮肤松弛症患者行上睑眼睑成形术在对比敏感度、散光及高阶像差方面的视觉功能有显著改善。
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