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Saba Alniemi, Ahsen Hussain, David Hodge, Elizabeth Bradley; Surgical Outcomes and Dry Eye Symptoms following Anterior or Posterior Approach Blepharoptosis Surgery in the Elderly Patient. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4747.
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Dry eye symptoms increase in the elderly and following blepharoptosis surgery. This study aims to compare the surgical outcomes and prevalence of dry eye symptoms following blepharoptosis surgery in patients ≥ 80-years-old when compared to younger, case matched controls.
A retrospective chart review of 166 patients ≥ 80-years-old who were post-blepharoptosis surgery (+/- blepharoplasty), through an anterior or posterior approach for involutional ptosis at the Mayo Clinic in Rochester, MN, between January 1, 1990 and December 31, 2010 was performed.<br /> A younger case matched control group of 169 patients ≥40 and ≤79-years-old who had undergone the same operation(s) within 12 months of one another was also reviewed. Patients with history of corneal graft, conjunctival surgery, ocular surface disease besides dry eye, history of trauma, previous ptosis surgery within the past 10 years, neurogenic ptosis, mechanical ptosis, or the inability to follow up within 6 months of surgery were excluded.<br />
A total of 335 consecutive patients were included in the study: 169 younger patients (mean age 67.4, SD 7.79) and 166 elderly patients (mean age 83.8, SD 3.37). The majority of patients were female (57%) and Caucasian (96.4%). There were more non-white patients in the younger group (p=0.02). The majority of patients (55.8%) underwent a combined levator advancement and blepharoplasty. Preoperatively, 134 patients (40%) reported dry-eye symptoms. At the first post-op visit (mean 14 days), 35 (10.5%) patients had new or worse dry-eye. This increased to 58 (17.3%) patients by the second post-op visit (performed within 6 months). No significant difference was found between the groups for new or worse dry-eye at the 1st or 2nd post-op visit (p=0.54). The presence of preoperative dry-eye had no relation to worsened symptoms by 6 months (p=0.17). Pre-operative mean reflex distance 1 (MRD1) was smaller (p=0.002) for the 80+ group. There was no significant difference in surgeon, gender, procedure type, MRD1 post-op, MRD1 asymmetry post-op, or complication rate between the two groups (p-values >0.05).<br />
Dry eye symptoms and adverse surgical outcomes were not found to be increased post-blepharoptosis surgery (+/- blepharoplasty) in the elderly population when compared to younger case-matched controls. <br />
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