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Kiral IA, Demirkesen S. Evaluating the impact of different hard hats on the peripheral vision of construction workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:436-449. [PMID: 38326238 DOI: 10.1080/10803548.2024.2316515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Construction safety is always an issue for construction workers. Hence, personal protective equipment plays a critical role in avoiding potential hazards on construction sites. Among these, hard hats protect against head contact with falling objects on construction sites. This study aims to examine the effects of hard hats with different peak lengths on the field of view at different angles in the upward part and to examine the effects of possible field of view losses caused by the hard hat on the reaction times of the workers. A questionnaire was designed and administered to the construction workers. Experiments were then conducted with a group of subjects to assess their peripheral vision level as well as reaction times. The study found that peripheral vision is affected by the peak size of hard hats. The study further revealed that there is a significant relationship between reaction times and hard hat peak size.
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Affiliation(s)
- Isik Ates Kiral
- Department of Civil Engineering, Bursa Technical University, Bursa, Turkey
| | - Sevilay Demirkesen
- Department of Civil Engineering, Gebze Technical University, Kocaeli, Turkey
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Ulas MG, Tukenmez Dikmen N. Effect of Upper Lid Blepharoplasty Surgery on Corneal Topography and Corneal High-Order Aberrations. Facial Plast Surg 2023; 39:581-585. [PMID: 36878679 DOI: 10.1055/a-2047-7405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
The objective of this study was to prospectively investigate the effect of upper eyelid blepharoplasty surgery for dermatochalasis on corneal topographic data and high-order aberrations (HOAs). Fifty eyelids of 50 patients with dermatochalasis who underwent upper lid blepharoplasty surgery were prospectively studied. A Pentacam (Scheimpflug camera, Oculus) device was used to measure corneal topographic values, astigmatism degree, and HOAs before and at 2 months after upper eyelid blepharoplasty. The mean age of the patients included in the study was 55.96 ± 12.4 years, 40 (80%) were female and 10 (20%) were male. We found no statistically significant difference in the pre-and postoperative values of corneal topographic parameters (p > 0.05 for all). In addition, we observed no significant postoperative change in the root mean square values of low, high, and total aberration values. In HOAs, we detected no significant change in spherical aberration, horizontal and vertical coma, and vertical trefoil; we only found a statistically significant increase in horizontal trefoil values after surgery (p < 0.05). In our study, we found that upper eyelid blepharoplasty did not cause significant changes in corneal topography, astigmatism, and ocular HOAs. However, studies are reporting different results in the literature. For this reason, it is important for patients considering upper eyelid surgery to be warned about visual changes that may occur after surgery.
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Affiliation(s)
- Mehmet Goksel Ulas
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Türkiye
| | - Nejla Tukenmez Dikmen
- Department of Ophthalmology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Türkiye
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Gumus G, Karabulut GO, Fazil K, Karaagac Gunaydin Z, Serefoglu Cabuk K, Akman D. Digital Evaluation of the Changes in Eyelid and Ocular Surface Measurements and the Correlation of These Parameters with Visual Field Parameters After Upper Eyelid Blepharoplasty. BEYOGLU EYE JOURNAL 2023; 8:115-122. [PMID: 37521887 PMCID: PMC10375205 DOI: 10.14744/bej.2023.24392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 08/01/2023]
Abstract
Objectives We aimed to evaluate the change in eyelid and ocular surface parameters that were measured using a digital measurement program, the change in the visual field (VF), and the correlation between ocular surface area (OSA) and VF parameters in patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis. Methods Patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis between August 2015 and August 2019 were included in the study. The difference between preoperative and postoperative 3rd month values of manually measured margin reflex distance 1 (MRD1), digitally measured eyelid and ocular surface parameters (MRD1, MRD 2 [MRD2], upper eyelid crease height [ECH], pretarsal show height [PTH], eyebrow line-height [EBH] and OSA), and VF parameters were evaluated. The correlation between preoperative and postoperative values of manually and digitally measured MRD1 and also preoperative and postoperative values of OSA and VF parameters were analyzed. Results Thirty-six eyes from 36 patients were included in this study and the mean age of patients was 57.93±7.64 years. There were statistically significant changes between preoperative and postoperative values in means of the manually measured MRD1 and the digitally measured MRD1, PTH, OSA, and ECH (p<0.001). However, the postoperative changes in the mean MRD2 and EBH were not statistically significant (p=0.664 and p=0.983). There were moderate positive correlations between pre- and post-operative OSA values and pre- and postoperative values of manual and digital MRD1. A statistically significant agreement was observed between the change in OSA and the change in all VF parameters (Bland-Altman analysis test). Conclusion Digital measurements can be used to evaluate the changes in eyelid and ocular surface parameters in patients who underwent upper eyelid blepharoplasty surgery. OSA provides fast results in accordance with linear measurements and is compatible with the change in the VF.
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Affiliation(s)
- Gulsah Gumus
- Department of Ophthalmology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Türkiye
| | - Gamze Ozturk Karabulut
- Department of Ophthalmology, University of Health Sciences Beyoglu Eye Training and Research Hospital, Beyoglu, Istanbul, Türkiye
| | - Korhan Fazil
- Department of Ophthalmology, University of Health Sciences Beyoglu Eye Training and Research Hospital, Beyoglu, Istanbul, Türkiye
| | | | - Kubra Serefoglu Cabuk
- Department of Ophthalmology, University of Health Sciences Beyoglu Eye Training and Research Hospital, Beyoglu, Istanbul, Türkiye
| | - Damla Akman
- Department of Public Health, Celal Bayar University, Manisa, Türkiye
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Labkovich M, Warburton AJ, Ying S, Valliani AA, Kissel N, Serafini RA, Mathew R, Paul M, Hovstadius SM, Navarro VN, Patel A, Reddy H, Chelnis JG. Virtual Reality Hemifield Measurements for Corrective Surgery Eligibility in Ptosis Patients: A Pilot Clinical Trial. Transl Vis Sci Technol 2022; 11:35. [PMID: 36282119 DOI: 10.1167/tvst.11.10.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We developed an accelerated virtual reality (VR) suprathreshold hemifield perimetry algorithm, the median cut hemifield test (MCHT). This study examines the ability of the MCHT to determine ptosis severity and its reversibility with an artificial improvement by eyelid taping on an HTC Vive Pro Eye VR headset and the Humphrey visual field analyzer (HVFA) to assess the capabilities of emerging technologies in evaluating ptosis. Methods In a single visit, the MCHT was administered along with the HVFA 30-2 on ptotic untaped and taped eyelids in a randomized order. The primary end points were a superior field visibility comparison with severity of VF loss and VF improvement after taping for MCHT and HVFA. Secondary end points included evaluating patients' Likert-scaled survey responses on the comfort, speed, and overall experience with both testing modalities. Results VR's MCHT superior field degrees visible correlated well for severe category margin to reflex distance (r = 0.78) compared with HVFA's (r = -0.21). The MCHT also demonstrated noninferiority (83.3% agreement; P = 1) against HVFA for detection of 30% or more superior visual field improvement after taping, warranting a corrective surgical intervention. In comparing hemi-VF in untaped eyes, both tests demonstrated relative obstruction to the field when comparing normal controls to severe ptosis (HVFA P < 0.05; MCHT P < 0.001), which proved sufficient to demonstrate percent improvement with taping. The secondary end point of patient satisfaction favored VR vision testing presentation mode in terms of comfort (P < 0.01), speed (P < 0.001), and overall experience (P < 0.01). Conclusions This pilot trial supports the use of MCHT for the quantitative measurement of visual field loss owing to ptosis and the reversibility of ptosis that is tested when conducting a presurgical evaluation. We believe the adoption of MCHT testing in oculoplastic clinics could decrease patient burden and accelerate time to corrective treatment. Translational Relevance In this study, we look at vision field outputs in patients with ptosis to evaluate its severity and improvement with eyelid taping on a low-profile VR-based technology and compare it with HVFA. Our results demonstrate that alternative, portable technologies such as VR can be used to grade the degree of ptosis and determine whether ptosis surgery could provide a significant superior visual field improvement of 30% or more, all while ensuring a more comfortable experience and faster testing time.
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Affiliation(s)
- Margarita Labkovich
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew J Warburton
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephanie Ying
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aly A Valliani
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas Kissel
- Department of Statistics & Data Science, Carnegie Mellon, Pittsburgh, PA, USA
| | - Randal A Serafini
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raj Mathew
- Department of Medical Education, SUNY Downstate, Brooklyn, NY, USA
| | - Megan Paul
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Malin Hovstadius
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vicente N Navarro
- Department of Uro Onc Research, Weill Cornell Medicine, New York, NY, USA
| | - Aashay Patel
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Harsha Reddy
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James G Chelnis
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline: Eyelid Surgery for Upper Visual Field Improvement. Plast Reconstr Surg 2022; 150:419e-434e. [PMID: 35895522 DOI: 10.1097/prs.0000000000009329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A group of experts from different disciplines was convened to develop guidelines for the management of upper visual field impairments related to eyelid ptosis and dermatochalasis. The goal was to provide evidence-based recommendations to improve patient care. METHODS A multidisciplinary group of experts representing their specialty organizations was selected. A systematic literature review was performed including topics regarding documentation of the underlying cause for visual field impairment, selection of an appropriate surgical repair, assessment of the type of anesthesia, the use of adjunctive brow procedures, and follow-up assessments. The Grading of Recommendations, Assessment, Development, and Evaluation methodology process was used to evaluate the relevant studies. Clinical practice recommendations were developed using BRIDGE-Wiz (Building Recommendations In a Developers' Guideline Editor) software. RESULTS Each topic area was assessed. A clinical recommendation was made, and the relevant literature was discussed. CONCLUSIONS The review of the literature revealed varied complication rates and diverse treatment modalities for the correction of upper visual field deficit. Strong recommendations could not be made in most topic areas because of a paucity of methodologically sound studies in the literature. More rigorously designed studies are needed to measure outcomes of interest, with fewer sources of potential error or bias. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Taniguchi A, Yunoki T, Otsuka M, Hayashi A. Visual field changes in glaucoma patients after blepharoptosis surgery. Eur J Ophthalmol 2022; 32:3353-3357. [PMID: 35001702 DOI: 10.1177/11206721211073254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine changes in parameters of the visual field test before and after blepharoptosis surgery in patients with glaucoma. METHODS Twenty-three eyes of 14 glaucoma patients who underwent blepharoptosis surgery at Toyama University Hospital between July 2015 and September 2020 were included in this study. Pre- and post-operative values for the mean deviation (MD), pattern standard deviation (PSD) and total deviation (TD) of the upper or lower hemi-visual field in the Humphrey visual field test, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and margin reflex distance (MRD)-1 were compared. RESULTS MRD-1 showed a significant improvement after blepharoptosis surgery (preoperative MRD-1: 1.0 ± 0.82 mm, postoperative MRD-1: 3.26 ± 0.66 mm, p < 0.001). There were no significant differences in BCVA, IOP, MD and PSD values before and after surgery. On the other hand, there was a significant improvement in the superior TD (preoperative: -11.29 ± 6.57 dB, postoperative: -9.88 ± 7.31 dB, p = 0.044) although no significant difference was detected in the inferior TD postoperatively. The preoperative parameters of 2 groups (improvement and non-improvement groups of postoperative superior TD) were compared. Preoperative MD and superior TD were significantly lower in the improvement group (p = 0.03, p = 0.004, respectively), although there was no significant difference in preoperative PSD and inferior TD between the two groups. CONCLUSION In glaucoma patients, blepharoptosis may interfere with accurate visual field assessment, especially of superior TD.
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Affiliation(s)
- Aya Taniguchi
- Departments of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, 34823University of Toyama, Toyama, Japan
| | - Tatsuya Yunoki
- Departments of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, 34823University of Toyama, Toyama, Japan
| | - Mitsuya Otsuka
- Departments of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, 34823University of Toyama, Toyama, Japan
| | - Atsushi Hayashi
- Departments of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, 34823University of Toyama, Toyama, Japan
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Fukushima M, Yunoki T, Otsuka M, Hayashi A. Association of Deepening of the Upper Eyelid Sulcus with the Incidence of Blepharoptosis after Glaucoma Filtration Surgery. Semin Ophthalmol 2020; 35:348-351. [PMID: 33356827 DOI: 10.1080/08820538.2020.1863435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To examine the clinical characteristics of patients who developed blepharoptosis after filtering surgery. Study Design: A retrospective, observational study. Methods: 96 eyes in 79 patients who underwent glaucoma filtration surgery were included in this study. These patients were followed up for more than one year after filtration surgery. The clinical characteristics were compared between two groups: a group that developed blepharoptosis during the follow-up, and a group that did not develop blepharoptosis. Results: Of the 96 eyes in 79 patients who underwent filtration surgery, 12 eyes (12.5%) developed blepharoptosis and underwent blepharoptosis surgery. There were no significant differences between the two groups in any of the following: age, sex, presence or absence of simultaneous cataract surgery, differences in surgical procedures (conventional trabeculectomy or trabeculectomy with an Ex-Press mini-glaucoma shunt device), number of needlings after filtration surgery, glaucoma type and number of anti-glaucomatous drugs before filtration surgery. Deepening of the upper eyelid sulcus (DUES) was found in 6 of the 12 eyes (50.0%) of the blepharoptosis group and 9 of the 84 eyes (10.7%) of the non-blepharoptosis group, and a significant difference was observed (p < .01). When blepharoptosis patients without DUES after filtration surgery were used as a reference, there was a significant difference in odds ratios between these patients and blepharoptosis patients with DUES (OR: 8.56; 95% CI: 2.30-32.21; p < .01). Conclusion: The development of blepharoptosis after filtration surgery is an important issue, and the presence of DUES may be a risk factor for postoperative blepharoptosis after glaucoma filtration surgery.
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Affiliation(s)
- Masaki Fukushima
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani , Toyama, Japan
| | - Tatsuya Yunoki
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani , Toyama, Japan
| | - Mitsuya Otsuka
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani , Toyama, Japan
| | - Atsushi Hayashi
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani , Toyama, Japan
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Affiliation(s)
| | - David J. Bradley
- Mayo Clinic Department of Cardiovascular Medicine, Mayo Foundation, Rochester, Minnesota
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Is formal visual field testing essential prior to upper eyelid surgery in a post-COVID-19 era? Eye (Lond) 2020; 35:1520-1521. [PMID: 32694599 PMCID: PMC7372540 DOI: 10.1038/s41433-020-1103-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022] Open
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Evaluation of Visual Field and Balance Function Alterations in Patients Who Underwent Dermatochalasis Surgery. J Ophthalmol 2020; 2020:1310947. [PMID: 32377411 PMCID: PMC7180500 DOI: 10.1155/2020/1310947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 02/25/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare perioperative visual field (VF), balance functions (BF), and changes in the other ocular parameters in patients undergoing upper eyelid dermatochalasis (DC) surgery. Methods One hundred and fifty-eight eyes of 79 patients who underwent DC surgery were included in the study. The VF, BF, intraocular pressure (IOP), pachymetry (PM), macular, and optic nerve measurements were recorded. Measurements were repeated at postoperative month 1. The preoperative and postoperative ocular measurements and the balance data were compared. Results Nineteen of 79 (24.05%) patients were male and 60 of 79 (75.95%) were female, while the mean age of the patients was 58.65 ± 7.38 years. There were statistically significant differences in terms of VF and macular thickness between the preoperative and postoperative values. The improvements in mean defect, standard loss variance, and mean sensitivity values of global VF parameters in both eyes were statistically significant after surgery. Central macular thickness, mean macular thickness, and macular volume decreased significantly in all eyes after surgery (p < 0.05). Conclusions Although a marked improvement was observed in VF and peripheral vision after surgery, no significant change was found in BF parameters including primarily falling risk. The significant change in the macular parameters was only remarkable, and we think that the decrease was due to subtle vasospasm. There is a need for further comprehensive studies including especially patients older than 65 with a view to understanding the effect of DC surgery on BF.
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Zloto O, Matani A, Sagiv O, Prat D, Ben Artsi E, Leshno A, Priel A, Ben Simon GJ. Changes in Refraction and Visual Acuity after Upper Eyelid Blepharoplasty versus Posterior Approach Ptosis Procedures. Ophthalmic Res 2020; 63:588-592. [PMID: 32135543 DOI: 10.1159/000506951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/02/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate surgically induced refractive changes (SIRC) and visual acuity (VA) changes after blepharoplasty combined with posterior approach ptosis surgery (Müller's muscle-conjunctival resection [MMCR]) versus upper eyelid blepharoplasty alone. METHODS In this prospective, comparative, clinical study on patients undergoing MMCR and blepharoplasty, comprehensive ophthalmic examinations were performed preoperatively and 3 months postoperatively. SIRC were calculated with the 10-step Holladay method. RESULTS Fifty-six patients participated in the study, 31 in the blepharoplasty group and 25 in the ptosis group. logMAR VA improved significantly after surgery in both groups (p < 0.001). In both groups, most patients showed significant changes in SIRC sphere and spherical equivalent of >0.5 D (blepharoplasty group: 61.29 and 67.74%; ptosis group: 72.72 and 72.72%, respectively). Patients undergoing combined blepharoplasty ptosis surgery showed the greatest SIRC cylinder. CONCLUSIONS Upper eyelid blepharoplasty with or without MMCR is associated with significant SIRC 3 months postoperatively. This may affect decision-making for all patients, especially for those who intend to seek refractive correction in addition to the index upper eyelid surgery.
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Affiliation(s)
- Ofira Zloto
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Adham Matani
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Oded Sagiv
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Daphna Prat
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Elad Ben Artsi
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Ari Leshno
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Ayelet Priel
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Guy J Ben Simon
- Goldschleger Eye Institute, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel,
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Glaucoma Filtering Bleb Analysis Before and After Aponeurotic Blepharoptosis Surgery. Ophthalmic Plast Reconstr Surg 2020; 36:45-48. [PMID: 31593038 DOI: 10.1097/iop.0000000000001456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of aponeurotic blepharoptosis surgery and the morphology of filtering bleb in patients with filtrating bleb. METHODS This retrospective case series included 7 consecutive patients (9 eyes) with filtering bleb after trabeculectomy. They underwent transcutaneous levator aponeurotic advancement from May 2018 to April 2019. The authors evaluated margin reflex distance-1 and intraocular pressure and analyzed filtering bleb morphology, such as filtering bleb volume, filtering bleb height, and filtering bleb wall thickness, using anterior segment optical coherence tomography before and after aponeurotic advancement. The authors also evaluated intra and postoperative complications. RESULTS The mean age was 75.6 ± 7.8 years; the mean duration from glaucoma surgery to blepharoptosis surgery was 36.9 ± 26.8 months; the mean follow-up after blepharoptosis surgery was 6.1 ± 2.9 months. The mean margin reflex distance-1 value changed significantly from 0.7 ± 0.8 mm before surgery to 3.3 ± 0.4 mm after surgery (p < 0.0001). The mean intraocular pressure showed no significant change from 12.9 ± 2.6 mm Hg before surgery to 12.7 ± 3.3 after surgery. In the filtering bleb analysis using anterior segment optical coherence tomography no significant differences were found, such as in bleb volume, height and wall thickness, before and after blepharoptosis surgery. There were no intraoperative complications in any of the cases. A postoperative corneal disorder was seen in 1 eye, but there was no infection of or damage to filtering bleb in any of the cases during the postoperative follow-up period. CONCLUSIONS In patients with glaucoma filtering bleb, transcutaneous levator aponeurotic ptosis surgery is considered to be safe and unlikely to affect the morphology of the filtering bleb or intraocular pressure in the short term.In patients with glaucoma filtering bleb, transcutaneous levator aponeurotic ptosis surgery is considered to be highly safe and unlikely to affect the morphology of the filtering bleb or intraocular pressure in the short term.
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Hollander MHJ, Contini M, Pott JW, Vissink A, Schepers RH, Jansma J. Functional outcomes of upper eyelid blepharoplasty: A systematic review. J Plast Reconstr Aesthet Surg 2018; 72:294-309. [PMID: 30528286 DOI: 10.1016/j.bjps.2018.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/12/2018] [Accepted: 11/18/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Various functional outcomes after upper blepharoplasty are reported in the literature. We systematically reviewed the literature to assess the objective and subjective functional effects of upper blepharoplasty. METHODS After a systematic search of four search engines (Pubmed, Embase, Cinahl and Cochraine), any study on objective and subjective (patient reported) functional outcome after upper blepharoplasty was subjected to a quality assessment for possible inclusion in the review. The intervention was defined as a solitary surgical upper blepharoplasty containing the removal of skin, with or without the removal of a strip of orbicularis oculi muscle and/or upper orbital fat. Eligible studies were randomized controlled trials, controlled trials, cohort studies and case series (n ≥ 10). RESULTS A total of 3525 studies were assessed, of which 28 studies were included in this systematic review. Favorable outcomes after an upper blepharoplasty were reported and included enlarged visual field, enhanced quality of life related to fewer headaches and improved vision. Furthermore, sensitivity of the eyelids decreased, with differences in recovery. Outcomes for eyebrow height, astigmatism, contrast sensitivity and eyelid kinematics were not consistent between the studies. No meta-analysis could be performed due to the limited scope of included studies and the great variety in outcomes and blepharoplasty techniques. CONCLUSIONS Upper blepharoplasty is accompanied by a great variety of beneficial functional outcomes including an increased visual field and improvement in headache- and vision-related quality of life. Further research is needed, especially where results are conflicting (effects on eye dryness and eyebrow height) and/or the data are limited (contrast sensitivity, astigmatism).
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Affiliation(s)
- M H J Hollander
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands.
| | - M Contini
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands
| | - J W Pott
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands
| | - R H Schepers
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands
| | - J Jansma
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen (UMCG), PO BOX 30.001, Groningen 9700 RB, The Netherlands
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