Abstract Listings 2026

Purpose

This study investigates long-term effect of external ptosis surgery on dry eye disease, focusing on meibomian gland function among other dry eye parameters, due to the controversial impact of ptosis surgery on dry eye.

Methods

This prospective case series included patients with involutional ptosis and no prior history of dry eye who underwent levator aponeurosis advancement procedure at least three years prior. Dry eye evaluation was evaluated preoperatively, 21 to 28 days postoperatively and at least three years postoperatively. Assessed parameters included the ocular surface disease index questionnaire (OSDI), tear break up time (TBUT), corneal and conjunctival fluorescein staining, tear meniscus height, meibomian gland loss (MGL) via meibography, meibomian gland disease grading, and Schirmer testing. Margin reflex distance1(MRD1) was measured as well.

Results

Twenty five eyes were included (mean age of 68.6 11.9 years) in the study. A significant improvement in upper lid MGL was observed both long-term vs preoperative and long-term vs short-term follow up (p=0.001). No significant changes were found in lower lid MGL, TBUT, corneal and conjunctival fluorescein staining, tear meniscus height, and Schirmer testing across time points. OSDI scores decreased in the long term postoperatively but did not reach statistical significance (p>0.05). MRD1 significantly increased postoperatively compared to preoperative values (p<0.0001), with no significant change between short- and long- term postoperative measurements (p=0.63)

Conclusion

Levator aponeurosis advancement procedure improves upper lid MGL and does not induce dry eye signs or symptoms over long-term follow-up based on both subjective and objective assessments.

Additional Authors

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