Skin-Only Versus Skin-Plus-Orbicularis Resection Blepharoplasty: An Elaborated Analysis of Early- and Long-Term Effects on Corneal Nerves, Meibomian Glands, Dry Eye Parameters, and Eyebrow Position
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY, cilt.39, sa.5, ss.479-486, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 39 Sayı: 5
- Basım Tarihi: 2023
- Doi Numarası: 10.1097/iop.0000000000002376
- Dergi Adı: OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
- Sayfa Sayıları: ss.479-486
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır
Özet
Purpose: 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. Methods: 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-plusorbicularis 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). Results: 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. Conclusions: 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.