Long-term changes in contrast-sensitivity, corneal topography and higher-order aberrations after upper eyelid blepharoplasty: A prospective interventional study

Purpose: The aim of this study was to analyze the long-term changes in visual parameters, that is, contrast sensitivity (CS) and higher-order aberrations (HOAs), and corneal topography in the patients undergoing upper eyelid blepharoplasty (UEB) for dermatochalasis. Methods: This was a prospective, single surgeon, intervention study including patients (=40 years age) having severe dermatochalasis with a minimum post-UEB follow-up of 12 months. The preoperative readings of CS (using Pelli-Robson chart), HOAs (using WaveLight ALLEGRO analyzer), and corneal topography (using topographic modeling system-4, Tomey corporation) were noted and compared at 3, 6, and 12 postoperative months. Results: We studied 30 patients (60 eyes) who underwent bilateral UEB. The majority of patients were females (n = 21,70%), and the mean age of patients was 56.53 +/- 9.06 years. The preoperative and postoperative values of LogMAR visual acuity, log CS value, corneal topography measurements (K1, K2, cylinder value, and the axis), optical aberrations (total HOAs; third-order-trefoil & coma; four-order-spherical aberrations and secondary astigmatism, and tetrafoil) were compared. At 12 months, the mean CS value, the majority of HOAs, and corneal topography (only cylinder values) showed a stable, statistically significant difference in the postoperative period. Conclusion: The UEB may produce long-term, visually-beneficial, optical, and corneal changes. The patients undergoing cataract surgery aiming for spectacle independence may gain additional visual benefits with UEB.