Abstract
Purpose To compare perioperative visual field (VF), balance functions (BF), and changes in the other ocular parameters in patients undergoing upper eyelid dermatochalasis (DC) surgery. Methods One hundred and fifty-eight eyes of 79 patients who underwent DC surgery were included in the study. The VF, BF, intraocular pressure (IOP), pachymetry (PM), macular, and optic nerve measurements were recorded. Measurements were repeated at postoperative month 1. The preoperative and postoperative ocular measurements and the balance data were compared. Results Nineteen of 79 (24.05%) patients were male and 60 of 79 (75.95%) were female, while the mean age of the patients was 58.65 ± 7.38 years. There were statistically significant differences in terms of VF and macular thickness between the preoperative and postoperative values. The improvements in mean defect, standard loss variance, and mean sensitivity values of global VF parameters in both eyes were statistically significant after surgery. Central macular thickness, mean macular thickness, and macular volume decreased significantly in all eyes after surgery (p < 0.05). Conclusions Although a marked improvement was observed in VF and peripheral vision after surgery, no significant change was found in BF parameters including primarily falling risk. The significant change in the macular parameters was only remarkable, and we think that the decrease was due to subtle vasospasm. There is a need for further comprehensive studies including especially patients older than 65 with a view to understanding the effect of DC surgery on BF.
Highlights
Dermatochalasis (DC) is the most frequent cause of acquired pseudoptosis, which causes a decrease in superior visual field (VF) due to the loosening of the upper lid skin, which is folded by the atrophy of the elastic tissue with advanced age [1, 2]
According to macular thickness and volume evaluation results; a statistically significant (p < 0.05) decrease was observed in Central macular thickness (CMT), mean macular thickness (MMT), and macular volume (MV) values measured in all eyes (Table 2). ere were no statistically significant differences in terms of optic nerve head parameters, retinal nerve fiber layer (RNFL), and ganglion cell layer (GCL) thickness between the preoperative and postoperative values in both eyes (Table 2)
While the balance functions in stability index (STI), Fourier Harmony Index (FHI), and weight distribution index (WDI) dimensions were measured in various body, head, and eye positions (Table 3), falling risk slightly decreased after the operation; no statistically significant difference was found (Table 3)
Summary
Dermatochalasis (DC) is the most frequent cause of acquired pseudoptosis, which causes a decrease in superior visual field (VF) due to the loosening of the upper lid skin, which is folded by the atrophy of the elastic tissue with advanced age [1, 2]. It was stated that the risk of falling in elderly people was higher since they were not able to detect the environmental threats because of VF defects [11] For those people having impaired vision, many vision-dependent activities and daily tasks are difficult or impossible to perform, reducing their ability to perform daily living activities and maintain independence, which has a negative impact on their quality of life [12]. Is method of posturography is based on the assessment of the vertical pressure fluctuations on four independent force plates, each placed beneath the two heels and toe parts of the subject while he/she stands in an upright position. Four basic parameters, which were the stability index (STI), Fourier Harmony Index (FHI), weight percentage and weight distribution index (WDI), heel to toe for the feet, and pressure patterns of left and right foot synchronization, were measured by the Tetrax device in 8 different positions and frequencies, respectively. Adding the standard scores for stability, Fourier intensities of ∼0.3 and ∼1.00 Hz, and synchronizations, a fall index is graded as minimum falling risk (0–36), moderate level (37–58), high level (58–100), according to which precautions and supportive treatment can be planned [8, 17]
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