Evaluation of Results and Patient Satisfaction of Patients who Underwent Upper Lid Blepharoplasty for Functional Purposes

Öz

To present the results of patients who underwent upper lid blepharoplasty for functional purposes and to evaluate their satisfaction with the operation process. The study was two-stage and the demographic, ophthalmological examination, operative, and postoperative follow-up data of patients who underwent functional upper lid blepharoplasty for upper lid dermatochalasis in the first phase were retrospectively analyzed. In the second stage of the study, the Glasgow Benefit Inventory (GBI) questionnaire was applied to the patients who completed their 6th-month postoperative controls in order to measure the experience of the patients during the treatment process. Thirty eyes of 15 patients, 5 male and 10 female (mean age 51.2±10.3), were included in the study. In the visual field test, several levels of upper visual field defects were detected in 24 of 30 eyes. Skin and muscle excision were performed in 28 eyes of 14 patients. Bilateral isolated skin excision was performed in only 1 patient. Preapeneurotic adipose tissue extraction was performed in 6 eyes of 3 patients. The duration of postoperative edema and ecchymosis was 7.4±0.8 days and patients used painkillers for a mean of 2.3±1.2 days. No serious complication was observed. 60% of the patients described an improvement in the visual field and decreased heaviness in the upper eyelid area and decreased feeling of fatigue. There was no patient who was dissatisfied during the operation process, and all patients stated that if they were back to the beginning, they would want to undergo the surgery again. The GBI questionnaire total score was 41.9±15.9. Sub-group scores, GBI general, social support, and physical life scores were 7.2±1.5, 11.1±0.8, and 50.7±6.2, respectively. Upper lid blepharoplasty surgery performed for functional reasons has a high success and satisfaction rate. Informing the patients who particularly hesitate over the surgery, about the pre-operative and post-operative period will reduce the hesitance about the operation and increase the demand for the operation.

Anahtar Kelimeler

• Blepharoplasty; Glaskow Benefit Inventory: quality of life

Fonksiyonel Amaçla Üst Kapak Blefaroplasti Yapılan Hastaların Sonuçları ve Hasta Memnuniyetlerinin Değerlendirilmesi

Öz

Fonksiyonel amaçla üst kapak blefaroplasti yapılan hastaların sonuçlarını sunmak ve operasyon sürecindeki memnuniyetlerini değerlendirmek. Çalışma iki aşamalı olup ilk aşamasında üst kapak dermatoşalazisi nedeniyle fonksiyonel üst kapak blefaroplasti operasyonu yapılan hastaların demografik, oftalmolojik muayene verileri, operasyona ait veriler ile operasyon sonrası takiplerine ait veriler retrospektif olarak incelenmiştir. Çalışmanın ikinci aşamasında hastaların tedavi sürecindeki deneyimlerini ölçmek amacıyla operasyon sonrası 6. ay kontrollerini tamamlayan hastalara Glaskow Benefit Inventory (GBI) anketi uygulanmıştır. Çalışmaya 5’i erkek 10’u kadın (ort. yaş 51.2±10.3) toplam 15 hastanın 30 gözü dahil edilmiştir. Görme alanı testinde 30 gözün 24’ünde değişik seviyelerde üst görme alanı defekti saptanmıştır. Ondört hastanın 28 gözünde cilt ile beraber kas eksizyonu yapılmıştır. Sadece 1 hastada bilateral izole cilt eksizyonu yapılmış olup 3 hastanın 6 gözünde ek olarak preapenevrotik yağ doku çıkarımı uygulanmıştır. Postoperatif ödem ve ekimoz süresi 7.4±0.8 gün olup hastalar 2.3±1.2 gün ağrı kesici kullanmışlardır. Hiçbir hastada ciddi bir komplikasyon görülmemiştir. Hastaların %60’ı üst göz kapağı bölgesinde ağırlık, yorgunluk hissinin azalma ve görme alanında iyileşme tarif etmiştir. Operasyon sonrası memnuniyetsiz kalan hasta olmayıp, hastaların tamamı en başa dönülse tekrar ameliyat olmak isteyeceklerini belirtmiştir. GBI anketi total skoru 41.9±15.9’dur. Alt boyut skorları GBI genel, sosyal destek ve fiziksel hayat skorları sırasıyla 7.2±1.5, 11.1±0.8 ve 50.7±6.2’dir. Fonksiyonel nedenlerle yapılan üst kapak blefaroplasti operasyonunun başarı ve memnuniyet oranı yüksektir. Özellikle operasyona ait çekinceleri olan hastaların operasyon sırası ve sonrası dönem ile ilgili bilgilendirilmesi operasyon ile ilgili çekincelerin azalmasına ve operasyona olan talebin artmasını sağlayacaktır.

Anahtar Kelimeler

• Blefaroplasti
• Glaskow Benefit Inventory
• yaşam kalitesi

Kaynakça

1. Nagi KS, Carlson JA, Wladis EJ. Histologic Assessment of Dermatochalasis: Elastolysis and Lymphostasis are Fundamental and Interrelated Findings. Ophthalmology. 2011;118(6):1205-10.
2. Shirado M. Dyslipidaemia and Age-related Involutional Blepharoptosis. J Plast Reconstr Aesthet Surg. 2012;65(6):e146-50.
3. An SH, Jin SW, Kwon YH, and et al. Effects of Upper Lid Blepharoplasty on Visual Quality in Patients with Lash Ptosis and Dermatochalasis. Int J Ophthalmol. 2016;9(9):1320-4.
4. Battu VK, Meyer DR, Wobig JL. Improvement in Subjective Visual Function and Quality of Life Outcome Measures after Blepharoptosis Surgery. Am J Ophthalmol. 1996;121(6):677-86.
5. Herruer JM, Prins JB, van Heerbeek N, and et al. Patient-reported Outcome Measurement in Upper Blepharoplasty: How to Measure What the Patient Sees. J Plast Reconstr Aesthet Surg. 2018;71(9):1346-51.
6. Klingenstein A, Hintschich C. Update on Upper Eyelid Blepharoplasty. Ophthalmologe. 2018;115(4):266-74.
7. Carroll RP, Mahanti RL. En Bloc Resection in Upper Eyelid Blepharoplasty. Ophthalmic Plast Reconstr Surg. 1992;8(1):47-9.
8. Brennan HG, Joseph BA. Delineating the Cleft in Upper Blepharoplasty. Arch Otolaryngol. 1979;105(9):515-8.

9. Robinson K, Gatehouse S, Browning GG. Measuring Patient Benefit from Otorhinolaryngological Surgery and Therapy. Ann Otol Rhinol Laryngol. 1996;105(6):415-22.
10. Uysal Y, Cakmaklioğullari M. Evaluation of the Quality of Life of Patients with External Dacryocystorhinostomy and Punktoplasty Operation. Turkiye Klinikleri Journal of Ophthalmology. 2019;28(4):239–49.
11. Naik MN, Honavar SG, Das S, and et al. Blepharoplasty: An Overview. J Cutan Aesthet Surg. 2009;2(1):6-11.
12. Lieberman DM, Quatela VC. Upper Lid Blepharoplasty: A Current Perspective. Clin Plast Surg. 2013;40(1):157-65.
13. Hoorntje LE, Lei B, Stollenwerck GA, and et al. Resecting Orbicularis Oculi Muscle in Upper Eyelid Blepharoplasty--A Review of the Literature. J Plast Reconstr Aesthet Surg. 2010;63(5):787-92.
14. Rohrich RJ, Coberly DM, Fagien S, and et al. Current Concepts in Aesthetic Upper Blepharoplasty. Plast Reconstr Surg. 2004;113(3):32e-42e.
15. Gradinger GP. Cosmetic Upper Blepharoplasty. Clin Plast Surg. 1988;15(2):289-97.
16. Saadat D, Dresner SC. Safety of Blepharoplasty in Patients with Preoperative Dry Eyes. Arch Facial Plast Surg. 2004;6(2):101-4.
17. Gulyás G. Improving the Lateral Fullness of the Upper Eyelid. Aesthetic Plast Surg. 2006;30(6):641-50.
18. van der Lei B, Timmerman IS, Cromheecke M, and et al. Bipolar Coagulation-assisted Orbital (BICO) Septoblepharoplasty: A Retrospective Analysis of a New Fat-saving Upper-eyelid Blepharoplasty Technique. Ann Plast Surg. 2007;59(3):263-7.
19. Castañares S. Classification of Baggy Eyelids Deformity. Plast Reconstr Surg. 1977;59(5):629-33.
20. Owsley JQ, Jr. Resection of the Prominent Lateral Fat Pad During Upper Lid Blepharoplasty. Plast Reconstr Surg. 1980;65(1):4-9.
21. Raschke GF, Bader RD, Rieger UM, and et al. Photo-assisted Analysis of Blepharoplasty Results. Ann Plast Surg. 2011;66(4):328-33.
22. Joshi AS, Janjanin S, Tanna N, and et al. Does Suture Material and Technique Really Matter? Lessons Learned from 800 Consecutive Blepharoplasties. Laryngoscope. 2007;117(6):981-4.
23. Mahroo OA, Hysi PG, Dey S, and et al. Outcomes of Ptosis Surgery Assessed Using a Patient-reported Outcome Measure: An Exploration of Time Effects. Br J Ophthalmol. 2014;98(3):387-90.
24. Maycock N, MacGregor C, Saunders DA, and et al. Long Term Patient-reported Benefit from Ptosis Surgery. Eye (Lond). 2015;29(7):872-4.
25. Smith HB, Jyothi SB, Mahroo OA, and et al. Patient-reported Benefit from Oculoplastic Surgery. Eye (Lond). 2012;26(11):1418-23.
26. Kamao T, Takahashi N, Zheng X, and et al. Changes of Visual Symptoms and Functions in Patients with and without Dry Eye after Lacrimal Passage Obstruction Treatment. Curr Eye Res. 2020;45(12):1590-7.
27. Heemraz BS, Lee CN, Hysi PG, and et al. Changes in Quality of Life Shortly after Routine Cataract Surgery. Can J Ophthalmol. 2016;51(4):282-7.
28. Taherian K, Atkinson PL, Shekarchian M, and et al. Comparative Study of the Subjective and Objective Grading of Ptosis Surgery Outcomes. Eye (Lond). 2007;21(5):639-42.