Üst Göz Kapağı Blefaroplasti Ameliyatı Sonrası Kornea Topografisi ve Korneal Wavefront Aberasyonların İncelenmesi

Year 2024, , 503 - 508, 12.01.2025

Derya Doğanay , Muhammed Yelkovan , Ayna Sariyeva Ismayilov

https://doi.org/10.32708/uutfd.1550274

Abstract

Bu prospektif, girişimsel çalışma ile dermatoşalazis hastalarına uygulanan üst göz kapağı blefaroplasti (ÜKB) ameliyatının kornea üzerine etkisi korneal topografi ile, görme fonksiyonuna etkisi ise görme keskinliği ve korneal wavefront aberasyonlar incelenerek araştırıldı. Kırk hastanın 80 göz kapağı ameliyattan en az 1 ay sonra değerlendirildi. Ameliyat öncesi ve sonrası görme keskinliği, düz keratometri, dik keratometri, ortalama keratometri, topografik astigmatizma, aks, santral kornea kalınlığı ve ön kamara derinliği değerleri açısından anlamlı fark yoktu (hepsi için p >0,05) Ameliyat öncesi ön kamara hacmi (ACV) 122,06±28,0 mm3 iken, ameliyat sonrası ACV 126,23±28,80 mm3 (p=0,045) idi. 6 mm’lik optik zonda, total korneal yüzey için root mean square-higher-order aberrations (RMS-HOAs) 0,331±0,115 μm'den, 0,255±0,106 μm'ye düştü (p<0,001). RMS-koma (Z₃¹) (p=0,841), RMS-trefoil (Z₃³) (p=0,866) ve RMS-quadrifoil (Z₄⁴) (p=0,932) değerleri benzerdi. RMS- spherical aberration (Z₄⁰) istatistiksel olarak anlamlı azaldı (0,398±0,301, 0,371±0,280, p=0,035). Sonuç olarak, ÜKB ameliyatı sonrası erken dönemde, korneal topografik ve aberometrik ölçümlerde değişiklikler gözlemlenmiştir.

Keywords

dermatoşalazis, kornea topografisi, wavefront aberasyonları, yüksek sıralı aberasyonlar

Analysis of Corneal Topography and Wavefront Aberrations after Upper Eyelid Blepharoplasty

Abstract

In this prospective, interventional study, the effect of upper eyelid blepharoplasty (UEB) surgery performed on dermatochalasis patients on the cornea was investigated by corneal topography, and its effect on visual function was investigated by examining visual acuity and corneal wavefront aberrations. Eighty eyelids of 40 patients were evaluated at least 1 month after surgery. No significant differences were found for visual acuity, flat keratometry, steep keratometry, average keratometry, topographic astigmatism, axis, central corneal thickness, and anterior chamber depth (p>0.05 for all). While preoperative anterior chamber volume (ACV) was 122.06±28.0 mm3, the postoperative ACV was 126.23±28.80 mm3 (p=0.045). Root mean square-higher-order aberrations for total corneal surface (RMS-HOAs) in a 6-mm optical zone decreased significantly from 0.331±0.115 μm to 0.255±0.106 μm (p<0.001). The RMS-coma (Z₃¹) (p=0.841), RMS-trefoil (Z₃³) (p=0.866), and RMS-quadrifoil (Z₄⁴) (p=0.932) values were similar. The RMS-spherical aberration (Z₄⁰) decreased significantly (0.398±0.301, 0.371±0.280, p=0.035). In conclusion, it was seen that UKB surgery can improve the topographic and aberrometric measurements of the cornea in the early postoperative period.

Keywords

dermatochalasis, corneal topography, wavefront aberrations, higher order aberrations

Ethical Statement

Consent was obtained from the patient. Ethics committee approval (number: 2011-KAEK-25 2023/05-14) was obtained from the Bursa Yuksek Ihtisas Training and Research Hospital’s local ethics committee.

Supporting Institution

Funding: There is no funding.

References

• 1.Damasceno RW, Avgitidou G, Belfort R Jr, et al. Eyelid aging: pathophysiology and clinical management. Arq Bras Oftalmol 2015; 78:328-31.
• 2.Bhattacharjee K, Misra DK, Deori N. Updates on upper eyelid blepharoplasty. Indian J Ophthalmol 2017;65:551-8.
• 3. Jacobs LC, Liu F, Bleyen I, et al. Intrinsic and extrinsic risk factors for sagging eyelids. JAMA Dermatol 2014; 150:836–43.
• 4.Meyer DR, Stern JH, Jarvis JM, Lininger LL. Evaluating the visual field effects of blepharoptosis using automated static perimetry. Ophthalmology 1993;100:651–8.
• 5.Hacker HD, Hollsten DA. Investigation of automated perimetry in the evaluation of patients for upper lidblepharoplasty. Ophthal Plast Reconstr Surg 1992; 8:250–5.
• 6.Kim JW, Lee H, Chang M, et al. What causes increased contrast sensitivity and improved functional visual acuity afterupper eyelid blepharoplasty? J Craniofac Surg 2013;24:1582-5.
• 7.Simsek IB, Yilmaz B, Yildiz S, Artunay O. Effect of upper eyelid blepharoplasty on vision and corneal tomographic changes measured by Pentacam. Orbit 2015;34(5): 263–7
• 8.Atalay K, Gurez C, Kirgiz A, Serefoglu Cabuk K. Does severity of dermatochalasis in aging affect corneal biomechanical properties? Clin Interv Aging 2016;11:659-64.
• 9.Su T, He Y, Liu S, et al. Transient Increase of WavefrontAberrations after Horizontal Rectus Muscle Surgery inExotropia. Curr Eye Res 2019;44(12):1393-8.
• 10.Rudolph M, Laaser K, Bachmann BO, et al. Corneal higher-order aberrations after Descemet's membrane endothelial keratoplasty. Ophthalmology 2012;119(3):528-35.
• 11.Shah M, Lee G, Lefebvre DR, et al. A cross-sectional survey ofthe association between bilateral topical prostaglandin analogue use and ocular adnexal features. PLoS One 2013; 1;8(5):e61638.
• 12.Altin Ekin M, Karadeniz Ugurlu S. Prospective analysis ofvisual function changes in patients with dermatochalasis after upper eyelid blepharoplasty. Eur J Ophthalmol 2019;30(5):978-84.
• 13.Bhattacharjee K, Misra D, Singh M, Deori N. Long-term changes in contrast-sensitivity, corneal topography and higher-order aberrations after upper eyelid blepharoplasty: Aprospective interventional study. Indian J Ophthalmol 2020;68(12):2906-10.
• 14.Brown MS, Siegel IM, Lisman RD. Prospective analysis of changes in corneal topography after upper eyelid surgery.Ophthalmic Plast Reconstr Surg 1999;15(6):378-383.
• 15.Zinkernagel MS, Ebneter A, Ammann-Rauch D. Effect of upper eyelid surgery on corneal topography. Arch Ophthalmol 2007;125(12):1610-2.
• 16.Kim HH, De Paiva CS, Yen MT. Effects of upper eyelidblepharoplasty on ocular surface sensation and tear production. Can J Ophthalmol 2007;42:739–42.
• 17.Aksu Ceylan N, Yeniad B. Effects of upper eyelid surgery onthe ocular surface and corneal topography. Turk J Ophthalmol 2022;52:50–6.
• 18.Ilhan C, Aydemir GA, Aydemir E. Changes in Intraocular Pressure and Ocular Biometry After Blepharoplasty. Aesthetic Plast Surg 2022;46(5):2295-300.
• 19.Koc H, Ozen S, Bayram U, Kanik A. Evaluation of early periodchanges in intraocular pressure, ocular biometry and anterior segment after upper eyelid blepharoplasty. Int Ophthalmol 2024; 3;44(1):2.
• 20.Applegate RA. Glenn Fry award lecture 2002: Wavefront sensing, ideal corrections and visual performance. Optom Vis Sci 2002; 81:167-77.
• 21.Sabermoghaddam AA, Zarei-Ghanavati S, Abrishami M. Effects of chalazion excision on ocular aberrations. Cornea 2023;32(6): 757–60.
• 22.Han DJ, Lee DH, Seo JW, Yum JH, Lee JH. Changes in Corneal Higher-order Aberrations and Astigmatism after Upper Eyelid Surgery. J Korean Ophthalmol Soc 2022;63(10):814-22.
• 23.Lee H, Jang S, Park M, Park J, Baek S. Effects of epiblepharon surgery on higher-order aberrations. JAAPOS 2016;20:226-31.
• 24.Rabinowitz YS. The genetics of keratoconus. Ophthalmol Clin North Am 2003;16:607-20.
• 25.Applegate RA, Sarver EJ, Khemsara V. Are all aberrations equal? J RefractSurg 2001;18:556-62.
• 26.Han W, Kwan W, Wang J, et al. Influence of eyelid position on wavefront aberrations. Ophthalmic Physiol Opt 2007;27:66–75.
• 27.Tzelikis PF, Akaishi L, Trindade FC, Boteon JE. Spherical aberration andcontrast sensitivity in eyes implanted with aspheric and spherical intraocularlenses: a comparative study. Am J Ophthalmol 2008;145:827-33.
• 28.Kuroda T, Fujikado T, Maeda N, Oshika T, Hirohara Y,Mihashi T. Wavefront analysis of higher-order aberrations in patients with cataract. J CataractRefract Surg 2002;28:438-44.13.