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The Cosmetic and Functional Outcomes of Combined Surgery for Periocular Aging; Changes in Visual Field and Corneal Topography

Year 2021, Volume: 54 Issue: 1, 1 - 6, 27.04.2021
https://doi.org/10.20492/aeahtd.721920

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

Year 2021, Volume: 54 Issue: 1, 1 - 6, 27.04.2021
https://doi.org/10.20492/aeahtd.721920

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
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original research article
Authors

Seda Çelik This is me

Evin Şingar

Yasemin Katircioglu

Nurten Unlu This is me

Publication Date April 27, 2021
Submission Date April 17, 2020
Published in Issue Year 2021 Volume: 54 Issue: 1

Cite

AMA Çelik S, Şingar E, Katircioglu Y, Unlu N. The Cosmetic and Functional Outcomes of Combined Surgery for Periocular Aging; Changes in Visual Field and Corneal Topography. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. April 2021;54(1):1-6. doi:10.20492/aeahtd.721920