Dericioğlu Volkan, Şan Burçin, Sevik Mehmet Orkun, Akkaya Turhan Semra
Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.
Ophthalmic Plast Reconstr Surg. 2023;39(5):479-486. doi: 10.1097/IOP.0000000000002376. Epub 2023 Mar 27.
To evaluate the early- and long-term effects of 2 different blepharoplasty techniques on corneal nerves, meibomian gland morphology, clinical parameters of dry eye disease (DED), and eyebrow position.
This prospective, interventional study included age-sex-matched blepharoplasty patients who had a skin-only resection (24 eyes of 12 patients; Group-S) or a skin-plus-orbicularis muscle resection (24 eyes of 12 patients; Group-M) procedure. Preoperative and postoperative parameters of in vivo corneal confocal microscopy (IVCCM; corneal nerve fiber density [CNFD], nerve branch density [CNBD], and nerve fiber length), meibomian gland area loss (MGAL), DED (Schirmer I test and noninvasive tear breakup time), and eyebrow heights (lateral [LBH] and central [CBH]) were evaluated and compared between the intervention groups ( ClinicalTrials.gov , NCT05528016).
Compared with baseline, the CNBD of Group-S (19.91 ± 7.66 vs. 16.05 ± 7.28 branches/mm 2 , p = 0.049) and CNFD of Group-M (19.52 ± 7.45 vs. 16.80 ± 6.95 fibers/mm 2 , p = 0.028) was significantly decreased at postoperative first week. However, in both groups, IVCCM parameters returned to baseline values at postoperative first month and first year ( p > 0.05). A significant MGAL increase was observed in Group-S (18.47 ± 5.43 vs. 19.94 ± 5.31, p = 0.030) and Group-M (18.86 ± 7.06 vs. 20.12 ± 7.01, p = 0.023) at the postoperative first year, demonstrating meibomian gland atrophy. Only significant changes were observed in Group-M in LBH (16.17 ± 2.45 vs. 16.67 ± 2.28 mm, p = 0.044) and CBH (17.33 ± 2.35 vs. 17.96 ± 2.31 mm, p = 0.004) at postoperative first year.
Blepharoplasty with or without orbicularis resection seems to have similar effects on IVCCM, DED, and MGAL parameters. However, incorporating an orbicularis muscle resection in a blepharoplasty operation could slightly elevate the eyebrow position.
评估两种不同的眼睑成形术技术对角膜神经、睑板腺形态、干眼疾病（DED）临床参数及眉位的早期和长期影响。
本前瞻性干预研究纳入年龄和性别匹配的接受单纯皮肤切除术（12例患者的24只眼；S组）或皮肤加眼轮匝肌切除术（12例患者的24只眼；M组）的眼睑成形术患者。对两组患者术前及术后的活体共聚焦显微镜检查（IVCCM）参数（角膜神经纤维密度[CNFD]、神经分支密度[CNBD]和神经纤维长度）、睑板腺面积损失（MGAL）、DED（Schirmer I试验和无创泪膜破裂时间）及眉高（外侧[LBH]和中央[CBH]）进行评估并比较（ClinicalTrials.gov，NCT05528016）。
与基线相比，S组术后第1周的CNBD（19.91±7.66对16.05±7.28分支/mm²，p = 0.049）及M组术后第1周的CNFD（19.52±7.45对16.80±6.95纤维/mm²，p = 0.028）显著降低。然而，两组的IVCCM参数在术后第1个月和第1年时均恢复至基线值（p>0.05）。术后第1年，S组（18.47±5.43对19.94±5.31，p = 0.030）和M组（18.86±7.06对20.12±7.01，p = 0.023）的MGAL均显著增加，表明睑板腺萎缩。术后第1年，仅M组的LBH（16.17±2.45对16.67±2.28mm，p = 0.044）和CBH（17.33±2.35对17.96±2.31mm，p = 0.004）出现显著变化。
行或不行眼轮匝肌切除术的眼睑成形术对IVCCM、DED和MGAL参数似乎有相似的影响。然而，在眼睑成形术中加入眼轮匝肌切除术可能会使眉位略有升高。
