Abstract
Purpose :
To compare post-operative outcomes up to 1 year in patients after blepharoplasty with and without glucocorticoid use within 1 year prior to surgery.
Methods :
A retrospective cohort study was performed using TriNetX (Cambridge, MA, USA): a federated electronic health record database comprised of US healthcare organizations. Patients with upper or lower eyelid blepharoplasty were identified by CPT code and stratified into two cohorts based on glucocorticoid use 1 year prior to surgery. Glucocorticoids included cortisone, prednisone, prednisolone, methylprednisolone, dexamethasone, betamethasone, and hydrocortisone. 1:1 propensity score matching separated two cohorts while controlling for baseline characteristic and comorbidities: age, BMI, gender, primary hypertension, diabetes mellitus, chronic lower respiratory disease, nicotine dependence, heart failure, and alcohol related disorders. Patients with ocular comorbidities were screened out. Primary post-operative outcomes included dry eye syndrome, lagophthalmos, conjunctival edema, dacryoadenitis, orbital and periorbital cellulitis, strabismus, diplopia, orbital hemorrhage, and acute conjunctivitis. 1-year relative risk of post-operative outcomes were compared between the groups; those with a p-value less than 0.05 being statistically significant.
Results :
17,804 patients were included in the analysis with 8,902 patients in each of the blepharoplasty with and without glucocorticoid use cohorts. The cohort receiving glucocorticoids in the past year had a statistically significant increased risk of post-operative dry eye syndrome (RR, 1.25; 95% CI, 1.16-1.36), lagophthalmos (RR, 1.55; 95% CI, 1.13-2.13), and conjunctival edema (RR, 3.9; 95% CI, 1.95-7.81). No significant difference in risk was attributable to either cohort regarding dacryoadenitis, orbital and periorbital cellulitis, strabismus, diplopia, orbital hemorrhage, and acute conjunctivitis.
Conclusions :
Pre-surgical glucocorticoid use up to one year may impact post-operative course following blepharoplasty. Patients receiving glucocorticoids up to one year prior were more likely to develop post-operative dry eye syndrome, lagophthalmos, and conjunctival edema. Appropriate patients should be counselled on such risk both before and after blepharoplasty.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.