# The Impact of Levator Muscle Advancement With and Without Upper Blepharoplasty on Dry-Eye Symptoms in Unilateral Ptosis: A Comparative Study

## TL;DR

This study examines how ptosis surgery with or without blepharoplasty affects dry-eye symptoms, finding temporary worsening that resolves over time.

## Contribution

The study provides new evidence on the temporary impact of ptosis and blepharoplasty surgeries on dry-eye symptoms and their eventual resolution.

## Key findings

- Groups A and B showed temporary increased dry-eye symptoms, most notably in Group B at 1- and 3-month follow-ups.
- Dry-eye parameters returned to near-baseline levels by 6 months in all groups.
- Combined ptosis and blepharoplasty procedures require preoperative counseling about temporary dry-eye risks.

## Abstract

This study investigates the effects of levator advancement, with and without upper blepharoplasty, on dry-eye symptoms in patients with unilateral ptosis. A total of 92 patients were included, divided into three groups based on surgical intervention: Group A (ptosis correction alone), Group B (ptosis correction with blepharoplasty), and Group C (blepharoplasty alone). Dry-eye parameters were assessed preoperatively and postoperatively at 1, 3, and 6 months using Tear Break-Up Time (TBUT), Schirmer test, corneal and conjunctival staining, and the Ocular Surface Disease Index (OSDI) questionnaire. Our findings indicate that patients in Groups A and B exhibited a temporary increase in dry-eye symptoms, with the most significant effects observed in Group B at the 1- and 3-month follow-ups. By 6 months, dry-eye parameters in all groups returned close to baseline levels, underscoring the reversible nature of these symptoms. This study highlights the importance of preoperative counseling regarding potential temporary dry-eye symptoms, particularly for patients undergoing combined ptosis and blepharoplasty procedures. The results support the safety of these surgical approaches, provided there is appropriate patient monitoring and management to ensure symptom resolution over time.