The Cosmetic and Functional Outcomes of Combined Surgery for Periocular Aging; Changes in Visual Field and Corneal Topography
Abstract
Purpose: To evaluate the visual field and corneal topographic findings which occur with combined surgeries in patients who have other involutional periocular changes in association with dermatochalasis.
Material and Method: Eighty eyelids of 40 patients were included in the study and the subjects were divided into 2 groups as additional eyelid pathology (Group 1) and additional eyebrow ptosis (Group 2). In the preoperative and postoperative 3rd month, Margin Reflex Distance-1 (MRD-1), corneal parameters obtained by high base topography device and visual field findings obtained by a visual field device were recorded and detailed ophtalmologic examination was performed.
Results: A mean elevation of 0.5 mm was observed in the MRD-1 values in both groups. Postoperatively, a marked reduction was observed in the rate of observing scotoma in the visual field and in MD and PSD values (p<0.001) in both groups. Among the corneal topography data, no significant change was observed in the anterior chamber depth and astigmatism axis, whereas a statistically significant increase was found in the strenght of refractivity of the most flat (K1), the most steep meridian (K2) (p<0.05). The postoperative astigmatism value was significantly higher in Group 1 (p<0.001) while the increase in Group 2 was not statistically significant (p=0.599).
Conclusions: More successful functional and cosmetic outcomes can be obtained following combined surgeries directed to different pathologies in involutional eyelid and eyebrow changes.
References
- 1) McCord CD, Codner MA. St.Louis.Aesthetic Surgery.Eyelid and Periorbital Surgery. ST. Louis, Missouri; 2008:133-395. 2) Putterman AM, Fagien S, Burroughs JR. The upper periorbita. In: Fagien S, ed. Putterman’s cosmetic oculoplastic surgery. 4th ed. Chicago: Saunders; 2008: 67-145. 3) Functional indications for upper and lower eyelid blepharoplasty. American Academy of Ophthalmology. Ophthalmology. 1995;102:693-695. 4) Golchet PR, Yu F, Goldberg R, Coleman AL. Recent trends in upper eyelid blepharoplasties in medicare patients in the United States from 1995 to 1999. Ophthal Plast Reconstr Surg. 2004;20:190-197. 5) Functional indications for upper and lower eyelid blepharoplasty. American Academy of Ophthalmology. Ophthalmology. 1991;98:1461-1463. 6) Hacker RD, Hollsten DA. Investigation of automated perimetry in the evaluation of patients for upper lid blepharoplasty.Ophthalmic Plastic Reconstr Surg. 1992; 8:250-5. 7) Zinkernagel MS, Ebneter A, Ammann-Rauch D. Effect of upper eyelid surgery on corneal topography. Arch Ophthalmol. 2007; 125:1610-2. 8) Raschke GF, Bader RD, Rieger UM, Schultze-Mosgau S. Photo-assisted analysis of blepharoplasty results. Ann Plast Surg. 2011; 66:328-33. 9) Carraway JH, Tran P. Blepharoplasty with ptosis repair. Aesthet Surg J. 2009; 29:54-61. 10) Brown MS, Putterman AM.The effect of upper blepharoplasty on eyelid position when performed concomitanly with Müller muscle-conjunctival resection.Ophthal Plast Reconstr Surg. 2000; 16:94-100. 11) Cho R. Single-suture technique for combined upper eyelid blepharoplasty and Mueller's muscle-conjunctiva resection. Ophthal Plast Reconstr Surg. 2013; 29:316-7. 12) Nakra T, Modjtahedi S, Vrcek I, Mancini R, Saulny S, Goldberg RA. Orbit. 2016 Dec; 35(6):324-327. 13) Massry MD. The lift and fill lower blepharoplasty.Ophthal Plast Reconstr Surg. 2012; 28:213-8. 14) Hidalgo DA. An integrated approach to lower blepharoplasty. Plast Reconstr Surg. 2011; 127:386-95. 15) Kosmin AS, Wishart PK, Birch MK. Apparent glaucomatous visual field defects caused by dermatochalasis. Eye (Lond). 1997; 11:682-6. 16) Dogan E, Akbas Kocaoglu F, Yalniz-Akkaya Z, Elbeyli A, Burcu A, Ornek F. Scheimpflug imaging in dermatochalasis patients before and after upper eyelid blepharoplasty. Semin Ophthalmol. 2015; 30:193-6. 17) Cahill KV, Burns JA, Weber PA. The effect of blepharoptosis on the field of vision. Ophthal Plast Reconstr Surg. 1987; 3:121-5. 18) Hacker HD, Hollsten DA. Investigation of automated perimetry in the evaluation of patients for upper lid blepharoplasty. Ophthal Plast Reconstr Surg. 1992; 8:250-5. 19) Brown MS, Siegel IM, Lisman RD. Prospective analysis of changes in corneal topography after upper eyelid surgery. Ophthal Plast Reconstr Surg. 1999; 15:378-83. 20) Merriam WW, Ellis FD, Helveston EM. Congenital blepharoptosis, anisometropia, and amblyopia. Am J Ophthalmol. 1980; 89:401-7. 21) Goggin M. Astigmatism and periocular hemangioma. Ophthalmology. 2008; 115:1854-5
Perioküler Yaşlanma İçin Yapilan Kombine Cerrahinin Kozmetik Ve Fonksiyonel Sonuçlari; Görme Alani Ve Kornea Topografisindeki Değişiklikler
Abstract
Amaç: Dermatoşalazisle birlikte bulunan diğer senil perioküler değişiklikleri olan olgularda kombine cerrahi ile ortaya çıkan görme alanı ve kornea topografik bulgularını değerlendirmek.
Gereç ve Yöntem: Çalışmaya 40 hastanın 80 göz kapağı dahil edildi ve olgular ek göz kapağı patolojisi (Grup 1) ve ek kaş pitozu (Grup 2) olarak 2 gruba ayrıldı. Ameliyat öncesi ve sonrası 3. ayda Marjin Refleks Mesafesi-1 (MRD-1), yüksek bazlı topografi cihazı ile elde edilen kornea parametreleri ve görme alanı cihazı ile elde edilen görme alanı bulguları kaydedildi ve ayrıntılı oftalmolojik inceleme yapıldı.
Bulgular: Her iki grupta MRD-1 değerlerinde ortalama 0.5 mm?lik yükselme gözlendi. Ameliyat sonrası her iki grupta görme alanında skotom varlığında ve MD ve PSD değerlerinde belirgin azalma (p <0.001) gözlendi. Kornea topografisi verileri arasında ön kamara derinliğinde ve astigmatizma ekseninde anlamlı bir değişiklik gözlenmezken; en düz (K1), en dik meridyen (K2) kırılma gücünde istatistiksel olarak anlamlı artış tespit edildi (p < 0.05). Postoperatif astigmatizma değeri preoperatif döneme göre Grup 1'de anlamlı olarak daha yüksek (p <0.001), Grup 2'de ise bu artış istatistiksel olarak anlamlı değildi (p = 0.599). Sonuçlar: Senil göz kapağı ve kaş değişikliklerinde farklı patolojilere yönelik uygulanan kombine cerrahiler sonrasında daha başarılı fonksiyonel ve kozmetik sonuçlar elde edilebilir.
References
- 1) McCord CD, Codner MA. St.Louis.Aesthetic Surgery.Eyelid and Periorbital Surgery. ST. Louis, Missouri; 2008:133-395. 2) Putterman AM, Fagien S, Burroughs JR. The upper periorbita. In: Fagien S, ed. Putterman’s cosmetic oculoplastic surgery. 4th ed. Chicago: Saunders; 2008: 67-145. 3) Functional indications for upper and lower eyelid blepharoplasty. American Academy of Ophthalmology. Ophthalmology. 1995;102:693-695. 4) Golchet PR, Yu F, Goldberg R, Coleman AL. Recent trends in upper eyelid blepharoplasties in medicare patients in the United States from 1995 to 1999. Ophthal Plast Reconstr Surg. 2004;20:190-197. 5) Functional indications for upper and lower eyelid blepharoplasty. American Academy of Ophthalmology. Ophthalmology. 1991;98:1461-1463. 6) Hacker RD, Hollsten DA. Investigation of automated perimetry in the evaluation of patients for upper lid blepharoplasty.Ophthalmic Plastic Reconstr Surg. 1992; 8:250-5. 7) Zinkernagel MS, Ebneter A, Ammann-Rauch D. Effect of upper eyelid surgery on corneal topography. Arch Ophthalmol. 2007; 125:1610-2. 8) Raschke GF, Bader RD, Rieger UM, Schultze-Mosgau S. Photo-assisted analysis of blepharoplasty results. Ann Plast Surg. 2011; 66:328-33. 9) Carraway JH, Tran P. Blepharoplasty with ptosis repair. Aesthet Surg J. 2009; 29:54-61. 10) Brown MS, Putterman AM.The effect of upper blepharoplasty on eyelid position when performed concomitanly with Müller muscle-conjunctival resection.Ophthal Plast Reconstr Surg. 2000; 16:94-100. 11) Cho R. Single-suture technique for combined upper eyelid blepharoplasty and Mueller's muscle-conjunctiva resection. Ophthal Plast Reconstr Surg. 2013; 29:316-7. 12) Nakra T, Modjtahedi S, Vrcek I, Mancini R, Saulny S, Goldberg RA. Orbit. 2016 Dec; 35(6):324-327. 13) Massry MD. The lift and fill lower blepharoplasty.Ophthal Plast Reconstr Surg. 2012; 28:213-8. 14) Hidalgo DA. An integrated approach to lower blepharoplasty. Plast Reconstr Surg. 2011; 127:386-95. 15) Kosmin AS, Wishart PK, Birch MK. Apparent glaucomatous visual field defects caused by dermatochalasis. Eye (Lond). 1997; 11:682-6. 16) Dogan E, Akbas Kocaoglu F, Yalniz-Akkaya Z, Elbeyli A, Burcu A, Ornek F. Scheimpflug imaging in dermatochalasis patients before and after upper eyelid blepharoplasty. Semin Ophthalmol. 2015; 30:193-6. 17) Cahill KV, Burns JA, Weber PA. The effect of blepharoptosis on the field of vision. Ophthal Plast Reconstr Surg. 1987; 3:121-5. 18) Hacker HD, Hollsten DA. Investigation of automated perimetry in the evaluation of patients for upper lid blepharoplasty. Ophthal Plast Reconstr Surg. 1992; 8:250-5. 19) Brown MS, Siegel IM, Lisman RD. Prospective analysis of changes in corneal topography after upper eyelid surgery. Ophthal Plast Reconstr Surg. 1999; 15:378-83. 20) Merriam WW, Ellis FD, Helveston EM. Congenital blepharoptosis, anisometropia, and amblyopia. Am J Ophthalmol. 1980; 89:401-7. 21) Goggin M. Astigmatism and periocular hemangioma. Ophthalmology. 2008; 115:1854-5
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original research article |
| Authors | |
| Publication Date | April 27, 2021 |
| Submission Date | April 17, 2020 |
| Published in Issue | Year 2021 Volume: 54 Issue: 1 |
