# A New Classification of Dermatochalasis, the Effect of This Classification and Blepharoplasty Surgery on the Visual Field

## TL;DR

This paper introduces a new classification for dermatochalasis and shows that blepharoplasty surgery can improve visual field defects in severe cases.

## Contribution

A novel classification system for dermatochalasis based on eyelash contact and inversion, and evidence that blepharoplasty improves visual field in advanced stages.

## Key findings

- The new classification system correlates with the severity of visual field defects caused by dermatochalasis.
- Blepharoplasty significantly improved visual field parameters in stage 3 dermatochalasis cases.
- Changes in visual field were not significant in stage 1 and stage 2 cases before and after surgery.

## Abstract

The aim is to create a new classification according to the contact and effect of dermatochalasis on the eyelashes and to examine the effect of blepharoplasty surgery on the visual field (VF) in these stages.

Demographic characteristics of cases that were staged as dermatochalasis (group 1) (stage 1), (group 2) (stage 2), and (group 3) (stage 3) between February 2025 and April 2025 were examined, and changes in the VF before and after blepharoplasty were evaluated. Stage 1 was accepted as dermatochalasis only; stage 2 as dermatochalasis with eyelash contact but no eyelash inversion; and stage 3 as dermatochalasis creating inversion in the eyelashes. The Humphrey 30-2 test was applied in the VF. Mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and upper half VF sensitivity were evaluated. Those with refractive error and additional eye diseases were not included in the study.

A total of 60 cases were examined, 20 in each group. The mean age of the cases was 42.7 ± 14.9 (28-75). Forty of the cases were female and 20 were male. The mean age was higher in group 3, and there was a statistically significant difference (P < 0.05). The changes in the VF in group 1 and group 2 were not statistically significant preoperatively and in the first month postoperatively (P > 0.05). In group 3, MD was −2.88 ± 1.20 (−3.63-2.10) dB, VFI was 97.45 ± 1.61 (89-92) dB, upper half VF sensitivity was 22.21 ± 1.54 (17-18.40) dB, and PSD was 2.19 ± 0.87 (1.2-2.02) dB at postoperative first month. The changes in group 3 were statistically significant preoperatively and in the first month postoperatively (P < 0.05).

Dermatochalasis staging can predict the effect of dermatochalasis on the VF. This new dermatochalasis classification can be used in cases of equipment shortage. Visual field defects due to dermatochalasis can be corrected with blepharoplasty surgery.