CHARACTERIZATION OF THE CHANGES IN CORNEAL TOPOGRAPHY AND HIGHER ORDER ABERRATIONS IN PATIENTS UNDERGOING PTOSIS AND UPPER BLEPHAROPLASTY SURGERY

To determine changes in corneal topography and higher-order wavefront aberration in patients undergoing ptosis and upper eyelid blepharoplasty surgery.

Ophthalmology Department, Hospital Universitario Donostia

Prospective observational study including patients undergoing ptosis and upper blepharoplasty surgery at our hospital from June to September 2022. Patients were evaluated preoperatively and on day 7 and 30 after surgery. Corneal topography and Zernike analysis of the corneal wavefront aberration were performed during each visit. Outcome measures included: maximum keratometry (Kmax), mean keratometry (Km), corneal cylinder, axis of corneal cylinder, asphericity, total root mean square (RMS) and higher order aberrations (HOA) RMS. Topographic values were also studied for posterior cornea.

27 eyes from 16 patients were included in the study. 16 and 11 eyes underwent ptosis and upper eyelid blepharoplasty respectively. Mean age of the sample was 73 years old. 30 days after surgery we found statistically significant reductions in both subgroups for the next measures: Kmax, anterior and posterior corneal cylinder, total RMS and HOA RMS (p<0.05). Anterior cylinder decreased 0.63 and 0.35 diopters in the ptosis and upper blepharoplasty subgroups respectively. Axis of anterior corneal cylinder rotated 19.14º and 17.6º in the ptosis and upper blepharoplasty subgroups respectively. 57.14% of ptosis eyes suffered a change in the type of astigmatism after surgery. Regarding the different zernike coefficients analyzed, coma and trefoil suffered a statistically significant reduction in both subgroups. Patients receiving ptosis surgery underwent bigger changes in corneal topography and higher-order wavefront aberration than subjects undergoing upper eyelid blepharoplasty (p<0.05). No statistically significant changes were observed for Km and asphericity values after surgery.

We have demonstrated changes in corneal topography and higher-order wavefront aberration after ptosis and upper eyelid blepharoplasty surgery. The clinician should take into account these changes when considering future cataract and refractive procedures. The reduction of corneal higher-order wavefront aberration in these patients translates into an improved visual quality after surgery.