Demographic and physiological factors associated with clinically significant eyelid edema in patients following upper eyelid surgery

Purpose: To investigate demographic and physiological variables associated with clinically significant edema after upper eyelid surgery.Methods: A retrospective chart review was performed on patients who underwent blepharo-plasty or external levator advancement with or without lid crease formation between January 2018 and January 2021 at the University of Southern California. Age, sex, pertinent medical his-tory (medications causing edema and comorbidities), and pertinent surgical procedures were all collected. Postoperative photos were graded by two independent physician graders on a newly developed photographic scale ranging from 0 (no edema) to 3 (severe edema). Clinically significant edema of the eyelids was defined as Grade 3 edema at any postoperative point or >= Grade 1 edema after 90 days post operation. Patients without postoperative photos were excluded. Mann-Whitney U test , Fisher's exact test, and chi 2 test were used to compare groups with and without significant edema. All analyses were conducted using SAS version 9.4 (SAS Institute Inc.) with alpha= 0.05.Results: Out of 217 patients, East Asian participants had higher odds of developing edema than White participants (odds ratio, 7.92; CI, 3.15-19.93, p < 0.0001) and Hispanic participants (odds ratio, 3.47; CI, 1.51-7.97, p = 0.003). Southeast Asian participants also had higher odds of developing CSEE than White participants (odds ratio, 6.19; CI, 1.71-22.43, p = 0.006). Fifty -four (24.9%) patients had clinically significant edema. Although BMI, medical comorbidities, medication use, and age did not affect edema, there was a statistically significant relationship between race and incidence of edema ( p = 0.0001). Those in the CSEE group were also more likely to require reoperation ( p = 0.0143).Conclusions: There is a statistically significant relationship between Asian race and the in-cidence of clinically significant eyelid edema. CSEE is associated with a higher incidence of reoperation (c) 2022 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.