Digital Evaluation of the Changes in Eyelid and Ocular Surface Measurements and the Correlation of These Parameters with Visual Field Parameters After Upper Eyelid Blepharoplasty

Abstract

Objectives: We aimed to evaluate the change in eyelid and ocular surface parameters that were measured using a digital measurement program, the change in the visual field (VF), and the correlation between ocular surface area (OSA) and VF parameters in patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis.

Methods: Patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis between August 2015 and August 2019 were included in the study. The difference between preoperative and postoperative 3rd month values of manually measured margin reflex distance 1 (MRD1), digitally measured eyelid and ocular surface parameters (MRD1, MRD 2 [MRD2], upper eyelid crease height [ECH], pretarsal show height [PTH], eyebrow line-height [EBH] and OSA), and VF parameters were evaluated. The correlation between preoperative and postoperative values of manually and digitally measured MRD1 and also preoperative and postoperative values of OSA and VF parameters were analyzed.

Results: Thirty-six eyes from 36 patients were included in this study and the mean age of patients was 57.93±7.64 years. There were statistically significant changes between preoperative and postoperative values in means of the manually measured MRD1 and the digitally measured MRD1, PTH, OSA, and ECH (p<0.001). However, the postoperative changes in the mean MRD2 and EBH were not statistically significant (p=0.664 and p=0.983). There were moderate positive correlations between pre- and post-operative OSA values and pre- and postoperative values of manual and digital MRD1. A statistically significant agreement was observed between the change in OSA and the change in all VF parameters (Bland-Altman analysis test).

Conclusion: Digital measurements can be used to evaluate the changes in eyelid and ocular surface parameters in patients who underwent upper eyelid blepharoplasty surgery. OSA provides fast results in accordance with linear measurements and is compatible with the change in the VF.

Keywords: Blepharoplasty; digital measurement; ocular surface area; visual field.

Figure 1

(a) Measuring white to white as 11 mm, (b) Margin reflex distance 1 measurement, (c) Margin reflex distance 2 measurement, (d) Pretarsal show height measurement, (e) Eyebrow line height measurement, (f) Ocular surface area measurement, (g) Eyelid crease height measurement.

Figure 2

Bland–Altman analyses for postoperative–preoperative changes in the ocular surface area and visual field parameters. Difference OSA: The preoperative and postoperative ocular surface area difference, Diffference VFI: The preoperative and postoperative visual field index difference, Diffference MD: The preoperative and postoperative mean deviation difference, Diffference PSD: The preoperative and postoperative pattern standard deviation difference, Diffference Upper Half Visual Field Sensitivity: The preoperative and postoperative upper half visual field sensitivity difference.