Ocular Surface Rehabilitation Following Eyelid Malposition Surgery: Functional and Symptomatic Recovery
Author: Maria Angela Romeo
Base Hospital / Institution: Department of Ophthalmology, University Magna Graecia, 88100 Catanzaro, Italy
ePoster presentation
Abstract ID: 25-424
Purpose
To evaluate the impact of corrective eyelid surgery on ocular surface health in patients with eyelid malpositions, focusing on subjective symptoms, tear film stability, and epithelial integrity.
Methods
This prospective study included 55 eyes from 37 adults (mean age: 71.4 ± 11.9 years) with eyelid malpositions. 39 eyes with involutional ptosis underwent either levator aponeurosis advancement (n = 26) or frontalis suspension (n = 13); 13 eyes with ectropion and 3 with entropion were treated with lateral tarsal strip surgery. All patients were evaluated preoperatively and at 1 week, 1 month, and 3 months. Parameters included Ocular Surface Disease Index (OSDI), non-invasive tear break-up time (NI-BUT) via MS-39 (CSO, Italy), Schirmer I test, and Oxford grading of corneal/conjunctival staining. A subgroup analysis was conducted on 34 eyes (62%) with long-standing, symptomatic DED (median duration: 5 years) refractory to lubricant therapy.
Results
At 90 days, mean OSDI scores improved significantly (43.2 ± 11.6 to 29.1 ± 9.2; p<0.001), alongside an increase in NI-BUT (4.3 ± 1.2 to 7.0 ± 1.5 seconds; p<0.001). Oxford staining scores decreased (2.2 ± 0.6 to 1.1 ± 0.5; p=0.002), consistent with epithelial recovery. Schirmer I increased non-significantly (9.5 ± 3.7 to 11.1 ± 4.0 mm; p=0.08). Subgroup analysis showed comparable improvements in ptosis and ectropion patients, while entropion cases demonstrated delayed but eventual normalization of tear film parameters. Clinical recovery was progressive from one month onward, with maximal improvement at 90 days.
Conclusion
In patients with persistent DED, although a transient postoperative ocular surface imbalance was observed in the early phase, corrective eyelid surgery resulted in significant improvements in both subjective symptoms and objective tear film metrics. These results support its role not only in restoring eyelid function, but also in enhancing tear film dynamics and epithelial stability when combined with adequate medical therapy.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alessandra | Di Maria | Department of Ophthalmology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy |
| Alessandro | Gaeta | Department of Internal Medicine and Medical Specialties (DIMI), Università di Genova, 16132 Genova GE, Italy. |
| Vincenzo | Scorcia | Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy |
| Giuseppe | Giannaccare | Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy |
