Risk of Dry Eye Post Different Surgeries for Blepharoptosis Repair

Comparison Between Three Different Surgeries for Blepharoptosis Repair and Their Impact on Dry Eye Status

Blepharoptosis, inferodisplacement of the upper eyelid, can be congenital or acquired. Acquired Blepharoptosis is usually aponeurotic, due to stretching or disinsertion of the levator aponeurosis. Treatment is surgical and can be performed by three common procedures - Levator advancement, Müller's muscle-conjunctival resection procedure and White line advancement. A number of reports inspected the possibility that Blepharoptosis repair procedures may cause deterioration in dry eye status. The investigators would like to assess whether there is a difference between the different procedures in their influence on dry eye status.

patients undergoing surgical repair for aponeurotic ptosis by the procedure- Müller's muscle-conjunctival resection.

A transcutaneous procedure in which the Levator palpebrae aponeurosis is advanced and attached to the tarsus.

A transconjunctival procedure in which the Levator palpebrae aponeurosis is advanced and attached to the tarsus.

Dry eye status will be measured by a composite of tests, including Ocular surface disease index (OSDI) questionnaire (which indicates subjective status), and a number of objective tests - Shirmer test, Flurocein dye, Lissamine green dye and tear breakup time

Success will be assessed by comparison of margin reflex distance1 (MRD1) measurement before and after surgery

Inclusion Criteria: Ptosis which indicate surgical repair The ptosis must be suitable for repair in any of the procedures Exclusion Criteria: Systemic disease which may cause ocular surface disease (eg Sjogren disease) Previous orbital or eyelid surgery Significantly dry eyes