Publication: 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
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Date
2023-09-01
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Abstract
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-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). Results: Compared with baseline, the CNBD of Group-S (19.91 ± 7.66 vs. 16.05 ± 7.28 branches/mm2, p = 0.049) and CNFD of Group-M (19.52 ± 7.45 vs. 16.80 ± 6.95 fibers/mm2, 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.
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Tıp, Cerrahi Tıp Bilimleri, Göz Hastalıkları ve Cerrahisi, Sağlık Bilimleri, Medicine, Surgery Medicine Sciences, Eye Diseases and Surgery, Health Sciences, Klinik Tıp (MED), Klinik Tıp, CERRAHİ, GÖZ HASTALIKLARI, Clinical Medicine (MED), CLINICAL MEDICINE, SURGERY, OPHTHALMOLOGY, Cerrahi, Oftalmoloji, Surgery, Ophthalmology
Citation
DERİCİOĞLU V., ŞAN B., SEVİK M. O., AKKAYA TURHAN S., "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