J Korean Ophthalmol Soc.  2022 Oct;63(10):814-822. 10.3341/jkos.2022.63.10.814.

Changes in Corneal Higher-order Aberrations and Astigmatism after Upper Eyelid Surgery

• Han DJ
• Lee DH
• Seo JW
• Yum JH
• Lee JH

• KMID: 2534434
• DOI: http://doi.org/10.3341/jkos.2022.63.10.814

Abstract

Purpose
We investigated the effects of upper eyelid surgery on corneal higher-order aberrations and astigmatism.
Methods
We enrolled 38 patients (66 eyes) who underwent blepharoplasty and 48 (81 eyes) who underwent levator resection. The marginal reflex distance1 (MRD1), corneal astigmatism, and corneal higher-order aberrations were measured preoperatively, and at 6 months postoperatively, and the two groups were compared.
Results
Corneal astigmatism decreased significantly in the ptosis repair group (p < 0.001) but there was no significant change in the axis of astigmatism. Preoperative third-order and coma-like aberrations were significantly more common in the ptosis repair group than in the other group (p = 0.027 and p = 0.044, respectively); both decreased significantly after the operation (p = 0.030 and p = 0.006, respectively). The decrease in MRD1 and changes in the two aberrations showed a significantly stronger negative correlation in the ptosis repair group than in the other group (b = -0.186; p < 0.001 and b = -0.159; p < 0.001, respectively).
Conclusions
For patients with both cataract and ptosis, it is best to perform levator resection surgery before cataract surgery, because corneal higher-order aberrations and astigmatism are improved by levator resection. In turn, this reduces postoperative refractive error and improve vision quality.

Keyword

Astigmatism; Blepharoplasty; Higher order aberrations; Levator resection; Ptosis