Browse > Article
http://dx.doi.org/10.1055/s-0042-1751101

Study to the Effect of Involutional Blepharoptosis Surgery Using Objective and Subjective Parameters  

Asamura, Shinichi (Department of Plastic and Reconstructive Surgery, Wakayama Medical University)
Wada, Yoshitaka (Department of Plastic and Reconstructive Surgery, Wakayama Medical University)
Tanaka, Saiichi (Department of Ophthalmology, Wakayama Medical University)
Saika, Shizuya (Department of Ophthalmology, Wakayama Medical University)
Publication Information
Archives of Plastic Surgery / v.49, no.4, 2022 , pp. 473-478 More about this Journal
Abstract
Background We investigate the effect of involutional blepharoptosis (IB) surgery based on dry eye symptoms by analysis using objective and subjective measures. Methods We recorded various parameters from patients that underwent levator advancement surgery for IB, totaling 125 eyes (total 65 patients, 5 unilateral, 60 bilateral). Subjective assessment comprised a questionnaire on dry eye-related quality of life score (DEQS), a summary score calculated from DEQS, and six-grade evaluation, the patient's own measure of eye comfort. Objective assessment comprised marginal-reflex distance-1 (MRD-1), measurement of tear film breakup time, and superficial keratopathy (SPK) existence by slit lamp microscope. Results Subjective assessments showed that IB patients had improvement of dry eye symptoms and eye comfort when surgery increased MRD-1. On the other hand, objective assessments showed that the presence of SPK is suspected when the postoperative MRD-1 level is 3 mm or higher. Conclusion IB surgery must not only increase MRD-1 value, but also to perform maintenance of the appropriate ocular surface condition. From our parameters, we suggest postoperative MRD-1 value should be maintained at < 3 mm to safe and effective of IB surgery.
Keywords
involutional blepharoptosis; dry eye-related quality of life score questionnaire; marginal-reflex distance-1; tear film breakup time and superficial keratopathy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Shiraishi A, Sakane Y. Assessment of dry eye symptoms: current trends and issues of dry eye questionnaires in Japan. Invest Ophthalmol Vis Sci 2018;59(14):DES23-DES28   DOI
2 Aakalu VK, Setabutr P. Current ptosis management: a national survey of ASOPRS members. Ophthal Plast Reconstr Surg 2011;27(04):270-276   DOI
3 Rajagopalan K, Abetz L, Mertzanis P, et al. Comparing the discriminative validity of two generic and one disease-specific health-related quality of life measures in a sample of patients with dry eye. Value Health 2005;8(02):168-174   DOI
4 Chen WPD. Asian upper blepharoplasty. JAMA Facial Plast Surg 2018;20(03):249-250   DOI
5 Roussel T, Grutzmacher R, Coster D. Patterns of superficial keratopathy. Aust J Ophthalmol 1984;12(04):301-316   DOI
6 Huijing MA, van der Palen J, van der Lei B. The effect of upper eyelid blepharoplasty on eyebrow position. J Plast Reconstr Aesthet Surg 2014;67(09):1242-1247   DOI
7 Pereira LS, Hwang TN, Kersten RC, Ray K, McCulley TJ. Levator superioris muscle function in involutional blepharoptosis. Am J Ophthalmol 2008;145(06):1095-1098   DOI
8 Floegel I, Horwath-Winter J, Muellner K, Haller-Schober EM. A conservative blepharoplasty may be a means of alleviating dry eye symptoms. Acta Ophthalmol Scand 2003;81(03):230-232   DOI
9 Mertzanis P, Abetz L, Rajagopalan K, et al. The relative burden of dry eye in patients' lives: comparisons to a U.S. normative sample. Invest Ophthalmol Vis Sci 2005;46(01):46-50   DOI
10 Abetz L, Rajagopalan K, Mertzanis P, Begley C, Barnes R, Chalmers RImpact of Dry Eye on Everyday Life (IDEEL) Study Group. Development and validation of the impact of dry eye on everyday life (IDEEL) questionnaire, a patient-reported outcomes (PRO) measure for the assessment of the burden of dry eye on patients. Health Qual Life Outcomes 2011;9:111   DOI
11 Murchison AP, Sires BA, Jian-Amadi A. Margin reflex distance in different ethnic groups. Arch Facial Plast Surg 2009;11(05):303-305   DOI
12 Brooks AM, Grant G, Gillies WE. The influence of superficial epithelial keratopathy on the corneal endothelium. Ophthalmology 1989;96(05):704-708   DOI
13 Thygeson P. Clinical and laboratory observations on superficial punctate keratitis. Am J Ophthalmol 1966;61(5 Pt 2):1344-1349   DOI
14 Uchino M, Dogru M, Yagi Y, et al. The features of dry eye disease in a Japanese elderly population. Optom Vis Sci 2006;83(11):797-802   DOI
15 Sakane Y, Yamaguchi M, Yokoi N, et al. Development and validation of the Dry Eye-Related Quality-of-Life Score questionnaire. JAMA Ophthalmol 2013;131(10):1331-1338   DOI
16 Kato H, Yokoi N, Watanabe A, et al. Relationship between ocular surface epithelial damage, tear abnormalities, and blink in patients with dry eye. Cornea 2019;38(03):318-324   DOI
17 Kim HH, De Paiva CS, Yen MT. Effects of upper eyelid blepharoplasty on ocular surface sensation and tear production. Can J Ophthalmol 2007;42(05):739-742   DOI
18 Bahceci Simsek I. Association of upper eyelid ptosis repair and blepharoplasty with headache-related quality of life. JAMA Facial Plast Surg 2017;19(04):293-297   DOI
19 Prischmann J, Sufyan A, Ting JY, Ruffin C, Perkins SW. Dry eye symptoms and chemosis following blepharoplasty: a 10-year retrospective review of 892 cases in a single-surgeon series. JAMA Facial Plast Surg 2013;15(01):39-46   DOI
20 Watanabe A, Selva D, Kakizaki H, et al. Long-term tear volume changes after blepharoptosis surgery and blepharoplasty. Invest Ophthalmol Vis Sci 2014;56(01):54-58   DOI
21 Shields M, Putterman A. Re: "Muller muscle-conjunctival resection: effect on tear production". Ophthal Plast Reconstr Surg 2003;19(03):254-255   DOI
22 Noma K, Takahashi Y, Leibovitch I, Kakizaki H. Transcutaneous blepharoptosis surgery: simultaneous advancement of the levator aponeurosis and Muller's muscle (levator resection). Open Ophthalmol J 2010;4:71-75   DOI
23 Uemura K, Shirakawa U, Okuda K, et al. Essence of blepharoptosis surgery does rasises the eyelids, is not just cosmetic improvement: especially in the elderly patient. J Wakayama Med Soc 2022;73(01):9-14
24 Cahill KV, Bradley EA, Meyer DR, et al. Functional indications for upper eyelid ptosis and blepharoplasty surgery: a report by the American Academy of Ophthalmology. Ophthalmology 2011;118(12):2510-2517   DOI
25 Pacella SJ, Codner MA. Minor complications after blepharoplasty: dry eyes, chemosis, granulomas, ptosis, and scleral show. Plast Reconstr Surg 2010;125(02):709-718   DOI
26 McMonnies CW. Incomplete blinking: exposure keratopathy, lid wiper epitheliopathy, dry eye, refractive surgery, and dry contact lenses. Cont Lens Anterior Eye 2007;30(01):37-51   DOI
27 Federici TJ, Meyer DR, Lininger LL. Correlation of the vision-related functional impairment associated with blepharoptosis and the impact of blepharoptosis surgery. Ophthalmology 1999;106(09):1705-1712   DOI
28 Watanabe A, Kakizaki H, Selva D, et al. Short-term changes in tear volume after blepharoptosis repair. Cornea 2014;33(01):14-17   DOI
29 Hong JP, Park CJ, Suh HP. Importance of vascularity and selecting the recipient vessels of lower extremity reconstruction. J Reconstr Microsurg 2021;37(01):83-88   DOI
30 Wang MTM, Tien L, Han A, et al. Impact of blinking on ocular surface and tear film parameters. Ocul Surf 2018;16(04):424-429   DOI
31 Dailey RA, Saulny SM, Sullivan SA. Muller muscle-conjunctival resection: effect on tear production. Ophthal Plast Reconstr Surg 2002;18(06):421-425   DOI
32 Lee WB, McCord CD Jr, Somia N, Hirmand H. Optimizing blepharoplasty outcomes in patients with previous laser vision correction. Plast Reconstr Surg 2008;122(02):587-594   DOI
33 Moesen I, van den Bosch W, Wubbels R, Paridaens D. Is dry eye associated with acquired aponeurogenic blepharoptosis? Orbit 2014;33(03):173-177   DOI