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上睑手术对眼表面和角膜地形的影响。

Effects of Upper Eyelid Surgery on the Ocular Surface and Corneal Topography.

机构信息

İstanbul University, İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey

Eye Foundation Bayrampaşa Eye Hospital, İstanbul, Turkey

出版信息

Turk J Ophthalmol. 2022 Feb 23;52(1):50-56. doi: 10.4274/tjo.galenos.2021.63255.

Abstract

OBJECTIVES

To evaluate the effect of upper eyelid surgery on ocular surface and corneal topography.

MATERIALS AND METHODS

Patients who underwent upper eyelid blepharoplasty and/or blepharoptosis repair were evaluated prospectively. Tear film break-up time (TBUT), Schirmer tests, corneal staining pattern, Ocular Surface Disease Index questionnaire, corneal topography, and autorefractor parameters were measured preoperatively and at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively.

RESULTS

Thirty-two eyes of 20 patients (9 male, 11 female) were included in the study. The mean age was 44.8±18.9 years (range: 8-74). Patients were divided into the following 3 groups according to the type of surgery performed: upper eyelid blepharoplasty (group 1), upper eyelid blepharoplasty and levator advancement ptosis surgery (group 2), and levator advancement ptosis surgery (group 3). There was a significant decrease in Schirmer test results at 6 months in groups 1 and 2 but no change in group 3. TBUT values were decreased at 1 week in group 3 (p=0.028) and returned to baseline at 1 month. Corneal punctate staining was detected at 1 day and 1 week in all groups. On corneal topography, group 3 showed a significant change in K2 values (0.3 diopters) at 1 month (p=0.006). There was no statistically significant change in autorefractor measurements postoperatively compared to preoperative values (p>0.05).

CONCLUSION

Depending on the type of surgical procedure performed, blepharoptosis repair and upper eyelid blepharoplasty can lead to dry eye of varying severity that may persist at postoperative 6 months.

摘要

目的

评估上睑手术对眼表和角膜地形图的影响。

材料与方法

前瞻性评估接受上睑成形术和/或上睑下垂修复术的患者。术前和术后 1 天、1 周、1 个月、3 个月和 6 个月分别测量泪膜破裂时间(TBUT)、泪液分泌试验、角膜染色模式、眼表疾病指数问卷、角膜地形图和自动屈光仪参数。

结果

20 例患者(9 例男性,11 例女性)32 只眼纳入研究。平均年龄为 44.8±18.9 岁(范围:8-74 岁)。根据手术类型,患者分为 3 组:上睑成形术(组 1)、上睑成形术联合提上睑肌缩短术(组 2)和提上睑肌缩短术(组 3)。组 1 和组 2 的 Schirmer 试验结果在术后 6 个月显著下降,但组 3 无变化。组 3 的 TBUT 值在术后 1 周时下降(p=0.028),并在 1 个月时恢复至基线。所有组在术后 1 天和 1 周均出现角膜点状染色。在角膜地形图上,组 3 在术后 1 个月时 K2 值(0.3 屈光度)发生显著变化(p=0.006)。与术前相比,术后自动屈光仪测量值无统计学显著变化(p>0.05)。

结论

根据手术类型,上睑下垂修复术和上睑成形术可导致不同严重程度的干眼,这种情况可能会持续到术后 6 个月。

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