Ptosis surgery yields increase in dry eye compared to upper eyelid blepharoplasty

The results from a prospective comparative case series that examined the long-term effect of combined blepharoplasty and Müller muscle-conjunctival resection (MMCR) compared to an upper blepharoplasty procedure on dry eye syndrome demonstrated that patients who underwent MMCR showed signs of dry eye compared to the preop status after long-term follow-up.

Dry eye signs should be examined before MMCR surgery, and patients should be aware of the high risk of developing dry eye and the need for long-term treatment, according to the study researchers. In addition, surgeons should carefully consider performing MMCR for patients with severe dry eye.

Participants were divided into 2 groups: the blepharoplasty group included adult patients who underwent blepharoplasty at least 3 years earlier and the ptosis group consisting of adult patients who underwent MMCR with blepharoplasty at least 3 years earlier. Schirmer-test 2, tear break-up time (TBUT), fluorescein staining, and lissamine green (LG) staining were compared for all patients before the procedure, on postoperative day 90, and at the long-term follow-up.

The participants included 25 post-MMCR patients with a mean follow-up of 4.94 years and 15 post-blepharoplasty patients with a mean follow-up of 4.22 years. A significant increase in the postop LG and fluorescein staining scores was found compared to the preop scores in the ptosis group as well as a decrease in postoperative TBUT compared to the preop values. Those parameters were not significant in the blepharoplasty group.

Reference
Zloto O, Alcalay I, Klain B, Ben Simon G. The long-term effect on dry eye of posterior approach ptosis surgery vs upper eyelid blepharoplasty. Curr Eye Res. 2024:15:1-5. doi:10.1080/02713683.2024.2302546.