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Sharmini A. Balakrishnan, Victor M. Elner, Roni M. Shtein; Full-thickness Blepharotomy for Dry Eye Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3805.
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To evaluate the use of full-thickness anterior blepharotomy surgery for the treatment of dry eye disease.
Retrospective review of 44 eyes of 39 patients with signs and/or symptoms of dry eyes who underwent anterior blepharotomy between 2000-2010 by a single surgeon (VME). Inclusion criteria included preoperative dry eye signs and/or symptoms and postoperative follow-up of at least 1 month. Patients with thyroid eye disease were excluded from this analysis. Clinical variables recorded included mid-pupil to upper eyelid distance, degree of superficial punctuate keratopathy (SPK), and dry eye symptoms based on self-report. These parameters were evaluated preoperatively and at 1 week, 1 month, 3 months, and 1 year after surgery. Additionally, data were collected from the patients’ most recent evaluation. Data analysis was performed using paired t-tests.
Mean postoperative follow-up was 18.5 months (range, 1-71 months). Mid-pupil to upper eyelid distance was significantly decreased from preoperative measurement at each postoperative time point (p < 0.001). Severity of SPK was significantly improved at all postoperative visits (p < 0.01). Self-reported dry eye symptoms were improved in 78% of patients by their 1 week post-operative visit. Seventy-five percent of these patients maintained symptomatic improvement at their final follow-up.
Graded full thickness anterior blepharotomy is highly effective in lowering the upper eyelid position and providing substantial protective benefit for patients with ocular surface dryness, with postoperative improvement of dry eye signs and symptoms.
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