Tear condition following unilateral ptosis surgery

Orbit. 2015 Apr;34(2):66-71. doi: 10.3109/01676830.2014.982766. Epub 2014 Dec 4.


Purpose: To evaluate changes in tear film condition following unilateral ptosis surgery.

Methods: This interventional case series includes patients with unilateral blepharoptosis scheduled for ptosis surgery with no prior history of eye disease and surgery over a 2-year period. Tear film evaluation before surgery were performed, which included Schirmer test with and without anesthesia, and tear break up time (TBUT). Ptosis surgery included levator resection and frontalis sling. The previously mentioned tests were repeated 1, 3, and 6 months after surgery. Subjective symptoms related to dry eye also evaluated before and after surgery.

Results: A total of 83 patients including 46 (55.4%) male subjects with mean age of 26.2 ± 16.2 years were enrolled in the study. The most common cause of ptosis was congenital in 77 (92.8%) patients. Surgical intervention included levator resection in 56 (67.5%) cases and frontalis sling procedure in 27 (32.5%) cases. The result of surgery was good in 47 (56.6%) patients while under- and overcorrection were observed in 32 (39.8%) and 3 (3.6%) patients, respectively. Schirmer's test with and without anesthesia and TBUT after surgery revealed a decrease in tear quantity and quality after surgery with time. Patients who had subjective complaints from dryness after surgery only had shorter TBUT among the objective signs.

Conclusions: Ptosis surgery can decrease the quantity and quality of tears in operated eyes. Since some of these patients may need other types of operations in future, such as refractive or cataract surgery, evaluation of the tear condition before further surgery is prudent.

Keywords: Blepharoptosis; Schirmer’s test; lacrimal; tears.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blepharoplasty*
  • Blepharoptosis / physiopathology
  • Blepharoptosis / surgery*
  • Child
  • Child, Preschool
  • Dry Eye Syndromes / diagnosis
  • Dry Eye Syndromes / physiopathology
  • Female
  • Humans
  • Lacrimal Apparatus / physiology
  • Male
  • Middle Aged
  • Tears / chemistry
  • Tears / physiology*