Mak Felix H W, Ting Michelle, Edmunds Matthew R, Harker Anthony, Edirisinghe Mohan, Duggineni Sirisha, Murta Fabiola, Ezra Daniel G
Department of Mechanical Engineering, University College London, London, United Kingdom.
Moorfields Eye Hospital, UCL Institute of Ophthalmology NIHR Biomedical Research Centre for Ophthalmology, London, United Kingdom.
Plast Reconstr Surg Glob Open. 2020 Jul 21;8(7):e2991. doi: 10.1097/GOX.0000000000002991. eCollection 2020 Jul.
This study was undertaken to characterize the effects of upper eyelid blepharoplasty on blink dynamics and to evaluate the hypothesis that changes in blink dynamics following blepharoplasty are associated with postoperative dry eye.
The voluntary blink of 14 eyes of 7 patients with dermatochalasis undergoing upper eyelid blepharoplasty was recorded with a high-speed camera preoperatively and 6-8 months postoperatively, alongside a group of 11 controls. The images were analyzed for palpebral aperture, blink duration, and maximum velocity during opening and closing phases. Patients undergoing blepharoplasty were assessed for dry eye symptoms pre- and postoperatively at 6-8 months using the ocular surface disease index score.
Despite intraoperative orbicularis oculi resection, there was no significant compromise of blink duration or maximum velocity of eyelid opening or closure post-blepharoplasty. Postoperatively, patients had an increase in palpebral aperture compared with both preoperatively (8.71 versus 7.85 mm; = 0.013) and control groups (8.71 versus 7.87 mm; = 0.04). Postoperatively at 6-8 months, there was an increase in dry eye symptoms in 6 of 7 patients compared with preoperatively (ocular surface disease index, 16.6 versus 12.5; < 0.05). There was no positive correlation between the increase in palpebral aperture and the increase in dry eye symptoms ( = -0.4; = 0.30).
Using modern videographic technology, this study demonstrates that upper eyelid blepharoplasty results in an increase in resting palpebral aperture but has no effect on dynamic blink parameters. Changes in palpebral aperture or blink dynamics are unlikely to be the cause of dry eye syndrome following blepharoplasty.
本研究旨在描述上睑成形术对眨眼动力学的影响，并评估上睑成形术后眨眼动力学变化与术后干眼相关的假说。
对7例患有皮肤松弛症且接受上睑成形术患者的14只眼睛的自主眨眼，在术前及术后6 - 8个月用高速摄像机进行记录，同时记录一组11名对照者。对图像分析睑裂孔径、眨眼持续时间以及开合阶段的最大速度。对接受上睑成形术的患者在术后6 - 8个月使用眼表疾病指数评分评估干眼症状。
尽管术中切除了眼轮匝肌，但上睑成形术后眨眼持续时间或眼睑开合的最大速度并无显著受损。术后，患者的睑裂孔径与术前（8.71对7.85毫米；P = 0.013）及对照组（8.71对7.87毫米；P = 0.04）相比均增加。术后6 - 8个月时，7例患者中有6例的干眼症状较术前增加（眼表疾病指数，16.6对12.5；P < 0.05）。睑裂孔径增加与干眼症状增加之间无正相关（r = -0.4；P = 0.30）。
本研究使用现代摄像技术表明，上睑成形术导致静息睑裂孔径增加，但对动态眨眼参数无影响。睑裂孔径或眨眼动力学的变化不太可能是上睑成形术后干眼综合征的原因。
