Development of superior limbic keratoconjunctivitis after upper eyelid blepharoplasty surgery: support for the mechanical theory of its pathogenesis.

PURPOSE: To describe a unique presentation of superior limbic keratoconjunctivitis (SLK) that occurred after upper eyelid blepharoplasty and to review the literature regarding the current theories of SLK pathogenesis and its treatment.

METHODS: A 48-year-old woman presented with a 2-year history of irritation and foreign body sensation in both eyes that began immediately after bilateral upper eyelid blepharoplasty. Her symptoms were unresponsive to therapy with lubricating eyedrops and ointments, cyclosporine 0.05% drops, and silver nitrate cauterization. The patient subsequently underwent surgical resection of the superior bulbar conjunctiva in both eyes.

RESULTS: Complete resolution of SLK symptoms.

CONCLUSIONS: The pathogenesis of SLK has been associated with mechanical injury to the superior limbus and superior bulbar conjunctiva. The development of SLK after upper eyelid blepharoplasty in our patient supports this theory and should be considered a possible adverse consequence of blepharoplasty.