From Addressing Aesthetics and Soft Tissue to Visual Performance: Multifaceted Satisfaction Assessment in a Multicenter Study of Patients With Dermatochalasis

Background: In this study, we seek to answer the question: Does blepharoplasty for dermatochalasis alter visual performance? Objectives: We seek to determine the impact of blepharoplasty on visual performance (refraction, contrast sensitivity, and visual field) in patients with dermatochalasis. Methods: A total of 146 eyelids of 74 patients, 48 (64.9%) females and 26 (35.1%) males ranging from 40 to 68 years old, with dermatochalasis were analyzed prospectively. Refraction, contrast sensitivity, visual acuity, higher-order aberrations (HOAs), and mean deviation index (MDI) in the Humphrey visual field were evaluated and recorded before and at 2, 4, and 6 months after upper eyelid blepharoplasty. Results: At the latest follow-up, uncorrected and corrected distance visual acuity showed no significant differences (P >.05). Patients' contrast sensitivity increased significantly at all spatial frequencies under both conditions (P <.05) except at 12 cycles per degree in the photopic condition (P =.947). Mean astigmatism significantly decreased from -1.17 +/- 0.83 to -0.89 +/- 0.66 postoperatively (P =.001). Total HOAs decreased significantly from 0.59 +/- 0.13 mu m to 0.51 +/- 0.09 mu m (P <.01) after surgery. The root mean square of the spherical aberration (P <.01), vertical trefoil (P =.018), horizontal trefoil (P <.01), horizontal coma (P <.001), and vertical coma (P <.01) decreased significantly. The MDI of the Humphrey visual field increased significantly postoperatively at all times compared with preoperatively (P <.05). The Blepharoplasty Outcomes Evaluation questionnaire showed significant favorable satisfaction with visual quality indexes (P <.001). Conclusions: Upper lid blepharoplasty, in addition to its aesthetic effect, is an effective intervention to promote visual function and quality of life.