Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Complications of transcutaneous and transconjunctival lower eyelid blepharoplasty
Author: Parinaz Shams
ePoster Number: 225,00
Purpose
To determine the incidence of complications following lower eyelid blepharoplasty (LEB), such as lower eyelid retraction, severe conjunctival chemosis and dry eye symptoms (DES) and associated risk factors including pre-existing ocular disorders & concomitant upper eyelid or lateral canthal surgery
Methods
A retrospective medical record review of consecutive cases of LEB during a 7-year period. Patients with less than 3 months of postoperative follow-up, severe dry eye/ Sjögren syndrome and pre-excising chronic conjunctival chemosis were excluded from the study.
Results
A total of 150 cases met the study inclusion criteria. The average age was 60 years and follow-up of 8 months. Chemosis following LEB was noted in 33% of all patients and DES requiring > 2 months of intensive lubricating drops occurred in 22% of which 42% needed additional dry eye treatment (ADET) such as topical steroids or cyclosporin +/- punctal plugs. 25% had pre-operative DES of which 54% required >two months of intensive lubricating drops and 38% required ADET versus 22% & 3% respectively of those without DES. The incidences of DES and chemosis were significantly higher in patients who did not receive routine post-op topical steroids, the transcutaneous versus transconjunctival approach, concurrent upper eyelid blepharoplasty +/- ptosis repair, lateral canthopexy/plasty (P < .001), female gender, preoperative DES and history of refractive surgery (P < .05). Conjunctival chemosis was treated with topical steroids & intensive lubrication, 6% needed conjuntivotomy and in all cases resolved within 3 months.
Conclusion
Conjunctival chemosis & DES are common complications of LEB, resulting from ocular surface dryness and inflammation exacerbated by disrupted eyelid closure mechanics and lymphatic drainage. The routine use of topical steroids, intensive lubrication and temporary lateral tarsorrhaphy may reduce the incidence of post-operative chemosis in high-risk patients. Anatomical and pathophysiological causative factors and treatments to minimize and manage these complications are discussed.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Saul | Rajak | Sussex Eye Hospital and Brighton and Sussex University Hospital |
Abstract ID: 25-442
