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      Effects of Upper Eyelid Blepharoplasty on Contrast Sensitivity in Dermatochalasis Patients

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          Abstract

          Objectives:

          To evaluate the impact of upper eyelid blepharoplasty on contrast sensitivity in dermatochalasis patients.

          Materials and Methods:

          Best corrected visual acuity, ophthalmologic examination, eyelid examination, lash ptosis, contrast sensitivity using sine-wave contrast sensitivity chart, keratometric parameters, and corneal aberrations of 34 eyes of 34 patients who underwent upper eyelid blepharoplasty due to dermatochalasis in our clinic between the years 2014 and 2018 were evaluated preoperatively and at postoperative 3 months.

          Results:

          Twenty-three (68%) of the patients were females and 11 (32%) were males. Mean age was 63.1±7 (52-81) years. Mean best corrected visual acuity was 0.036±0.06 (0-0.15) logMAR preoperatively and postoperatively (p>0.05). Contrast sensitivity values of the patients at the frequencies of 1.5, 3, 6, 12, and 18 cycles per degree were 44.38±19.5, 59.03±27.2, 41.44±34.1, 15.15±19.3, and 5.15±4.26 preoperatively and 44.80±20.9, 76.85±33.4, 63.21±46.4, 28.21±31.1, and 10.5±9.5 postoperatively, respectively. The difference between contrast sensitivity values was statistically significant at the frequencies of 3, 6, 12, and 18 cpd (p=0.005, =0.001, <0.001, and <0.001, respectively). Although lash ptosis of the patients improved significantly after the surgery, there was no correlation between lash ptosis improvement and change in contrast sensitivity (p>0.05). Keratometric values and corneal high order aberrations did not change significantly after the surgery (p>0.05).

          Conclusion:

          Contrast sensitivity significantly increases after upper eyelid blepharoplasty, especially at higher spatial frequencies which are known to deteriorate due to age-related changes in the lens and retina in older adults. Our results show that blepharoplasty may have additional functional indications for elderly dermatochalasis patients in terms of improving the functions such as performing daily tasks and reading.

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          Most cited references25

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          Contrast sensitivity

          C Owsley (2003)
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            Age-related changes in corneal and ocular higher-order wavefront aberrations.

            To investigate age-related changes in ocular and corneal higher-order wavefront aberrations and elucidate relative contributions of the cornea and the lens in the age-related changes. Observational case series. Corneal and ocular higher-order wavefront aberrations in the central 6 mm diameter were measured with videokeratography and the Hartmann-Shack wavefront aberrometer in 75 normal eyes of 75 patients with a mean age of 43.5 +/- 11.7 years (range, 18-69 years). Higher-order wavefront aberrations were calculated with Zernike polynomials up to sixth order. From the Zernike coefficients, we calculated root mean square (RMS) of coma and spherical aberration. To examine age-related changes of the polarity of spherical aberration, the changes of the Zernike coefficient Z(4)(0) was also investigated. Both corneal (r =.307, P =.007) and ocular (r =.334, P =.0033) coma RMS showed positive correlations with age. There was a positive correlation between corneal and ocular coma RMS (r =.468, P <.0001). The RMS of corneal spherical aberration did not change with aging (r =.153, P =.1895), whereas the RMS of ocular spherical aberration had a positive correlation with aging (r =.308, P =.0068). These results suggest that the ocular coma increases with age, mainly because of the increase in the corneal coma, and the ocular spherical aberration increases with age, mainly because of the increase in the spherical aberration in the internal optics.
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              Higher-order aberrations after corneal collagen crosslinking for keratoconus and corneal ectasia.

              To determine changes in higher-order aberrations (HOAs) after corneal collagen crosslinking (CXL). Cornea and refractive surgery practice. Prospective randomized controlled clinical trial. Corneal and ocular HOAs were measured and analyzed using the Pentacam device and Ladarwave aberrometer, respectively, at baseline and 12 months after CXL. Ninety-six eyes (64 keratoconus, 32 ectasia) of 73 patients had CXL. A fellow-eye control group comprised 42 eyes. The mean preoperative total anterior corneal HOAs, total coma, 3rd-order coma, and vertical coma were 4.68 μm ± 2.33 (SD), 4.40 ± 2.32 μm, 4.36 ± 2.30 μm, and 4.04 ± 2.27 μm, respectively. At 1 year, the mean values decreased significantly to 4.27 ± 2.25 μm, 4.01 ± 2.29 μm, 3.96 ± 2.27 μm, and 3.66 ± 2.22 μm, respectively (all P<.001). There were no significant changes in posterior corneal HOAs. The mean preoperative total ocular HOAs, total coma, 3rd-order coma, trefoil, and spherical aberration were 2.80 ± 1.0 μm, 2.60 ± 1.03 μm, 2.57 ± 1.03 μm, 0.98 ± 0.46 μm, and 0.90 ± 0.42 μm, respectively. At 1 year, the mean values decreased significantly to 2.59 ± 1.06 μm, 2.42 ± 1.07 μm, 2.39 ± 1.07 μm, 0.88 ± 0.49 μm, and 0.83 ± 0.38 μm, respectively (all P=.01). After CXL, HOAs were significantly improved compared with the control group. Changes in HOAs were not statistically associated with an improvement in visual acuity or most subjective visual symptoms, however. Corneal and ocular HOAs decreased after CXL, suggesting an improvement in corneal shape. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Turk J Ophthalmol
                Turk J Ophthalmol
                TJO
                Turkish Journal of Ophthalmology
                Galenos Publishing
                2149-8695
                2149-8709
                June 2020
                27 June 2020
                : 50
                : 3
                : 151-155
                Affiliations
                [1 ]Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
                Author notes
                * Address for Correspondence: Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey E-mail: hilalnalci@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0003-4463-1413
                https://orcid.org/0000-0001-8686-1861
                https://orcid.org/0000-0002-3447-7785
                Article
                39756
                10.4274/tjo.galenos.2019.95871
                7338742
                32631001
                7f625367-2a86-406b-b774-ea8e655f6e3f
                © Copyright 2020 by Turkish Ophthalmological Association | Turkish Journal of Ophthalmology, published by Galenos Publishing House.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2019
                : 14 November 2019
                Categories
                Original Article

                blepharoplasty,contrast sensitivity,dermatochalasis,high order aberration,keratometry,pseudoptosis

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