Upper lid blepharoplasty in patients with LASIK.

PURPOSE: To investigate the changes in tear secretion and tear film stability after upper lid blepharoplasty in patients that had previously undergone excimer laser in situ keratomileusis (LASIK).

METHODS: We performed carbon dioxide (CO2) laser upper lid blepharoplasty to 18 eyes of 9 patients that had undergone bilateral LASIK at least 18 months before the surgery. Six women and 3 men aged 35 to 52 were included in this group. An additional control group of 18 eyes of similar age patients with no history of LASIK, contact lens usage or dry eye symptoms were studied. We studied the Schirmer tear test values without anesthesia at 5 minutes in both groups before and after the upper lid blepharoplasty procedure. Tear break-up time values were also measured before and 4 weeks after (CO2) laser upper lid blepharoplasty. The Schirmer tear test and tear break-up time values were analyzed statistically using the independent t-test.

RESULTS: The mean Schirmer tear test value was 19.07 +/- 4.03 mm in both eyes of the patients who had undergone LASIK and upper lid blepharoplasty, and it was 21.07 +/- 7.03 mm in the eyes of the control group that only had (CO2) laser upper lid blepharoplasty. The mean tear break-up time value was 21.0 +/- 3.55 seconds in the eyes that had LASIK treatment, and it was 21.27 +/- 6.79 seconds in the eyes of the control group. There was no statistical difference between the two groups.

CONCLUSION: Because LASIK and blepharoplasty both may cause dry eye symptoms, the possible cumulative effect of these surgeries is a serious consideration. However, dry eye symptoms after LASIK is usually temporary, and we may perform upper lid blepharoplasty to these patients after a certain time interval by closely monitoring their preoperative and postoperative tear function.