Purpose

To evaluate the effect of transconjunctival upper eyelid ptosis correction on the ocular surface.

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Methods

A prospective cohort study conducted in accordance with the Declaration of Helsinki. Patients aged >18 with acquired upper eyelid ptosis (MRD1 <2mm) and levator function ≥4mm were enrolled (2022–2024). Exclusions included moderate-to-severe dry eye disease, prior eyelid surgery, or systemic conditions affecting tear secretion. Group P underwent transconjunctival ptosis correction alone; Group PB underwent simultaneous ptosis correction with blepharoplasty. All procedures were performed by a single surgeon under local anesthesia. Assessments included MRD1, levator function, OSDI questionnaire, fluorescein corneal staining, tear break-up time (tBUT), and Schirmer test at baseline, 3, and 6 months postoperatively.

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Results

MRD1 improvement did not differ significantly between groups. Ptosis magnitude significantly worsened OSDI scores and tBUT at 3 months (p<0.001); however, these differences were not significant at 6 months. Schirmer test results remained stable throughout follow-up. Greater ocular surface disturbance was observed in Group PB compared to Group P.

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Conclusion

Transconjunctival upper eyelid ptosis correction induces transient ocular surface changes in the early postoperative period. A larger correction range correlates with greater ocular surface disturbance but, paradoxically, with higher patient satisfaction.

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Additional Authors

First name	Last name	Base Hospital / Institution
Michal	Kinasz	Military Institute of Medicine- National Research Institute, Department of Ophthalmology
Marek	Rekas	Military Institute of Medicine- National Research Institute, Department of Ophthalmology

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