Changes in Tear Meniscus and Corneal Epithelial Thickness Following Upper Blepharoplasty: A Systematic Review of Clinical Evidence from Anterior Segment OCT Studies

Upper eyelid blepharoplasty is a prevalent surgical intervention for dermatochalasis, but its effects on tear film stability and corneal epithelial thickness (CET) remain debated. Anterior Segment Optical Coherence Tomography (AS-OCT) provides precise, non-invasive measurements of tear meniscus parameters (TMH, TMA) and CET, offering insights into postoperative ocular surface changes. This systematic review synthesizes clinical evidence from AS-OCT studies to evaluate changes in tear meniscus and CET following upper blepharoplasty. A literature search has been performed in PubMed, Scopus, and Web of Science following PRISMA 2020 guidelines. Inclusion criteria comprised clinical researches reporting pre-and postoperative AS-OCT measurements of TMH, TMA, or CET. Five studies (prospective and observational) met eligibility criteria, with sample sizes ranging from 25 to 60 cases. Methodological quality has been evaluated utilizing the Newcastle-Ottawa Scale. Postoperative increases in TMH and superior CET were statistically significant, suggesting reduced mechanical pressure from the upper eyelid. TMA and central CET showed inconsistent changes. Transient tear film alterations were noted, with normalization by three months. AS-OCT demonstrated high reproducibility in tracking these metrics. Upper blepharoplasty may improve tear film dynamics and superior corneal epithelial remodeling, as quantified by AS-OCT. However, variability in outcomes underscores the need for larger, standardized studies to confirm these benefits and optimize surgical approaches for ocular surface health.

• Publication year

  2025

• Venue

  Benha Medical Journal

• Publication date

  2025-09-30

• Fields of study

  Not labeled

• Identifiers
  DOI 10.21608/bmfj.2025.413258.2611
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• Anatomy, Head and Neck, Eye Orbicularis Oculi Muscle

  2020influential reference
• Anatomy, Head and Neck, Eye Superior Oblique Muscle

  2020cited by this paper
• The effect of a ptosis procedure compared to an upper blepharoplasty on dry eye syndrome.

  2019cited by this paper
• Wide Corneal Epithelial Mapping Using an Optical Coherence Tomography.

  2018cited by this paper
• Optical coherence tomography for ocular surface and corneal diseases: a review

  2018cited by this paper
• A case of unilateral circumscribed posterior keratoconus evaluated by three different imaging tools: optical coherence tomography, videokeratography, and Scheimpflug corneal tomography

  2017cited by this paper
• Effects of Muller’s muscle-conjunctival resection for ptosis on ocular surface scores and dry eye symptoms

  2017cited by this paper
• Facial Nerve Supply to the Orbicularis Oculi around the Lower Eyelid: Anatomy and Its Clinical Implications.

  2017cited by this paper
• Upper Lid Blepharoplasty.

  2016cited by this paper
• Effect of Upper Eyelid Blepharoplasty on Vision and Corneal Tomographic Changes Measured By Pentacam

  2015cited by this paper
• Assessment of lower tear meniscus measurements obtained with Keratograph and agreement with Fourier-domain optical-coherence tomography

  2015cited by this paper
• Techniques in Ophthalmic Plastic Surgery with DVD. A Personal Tutorial

  2015influential reference
• Dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty measured by optical coherence tomography.

  2014cited by this paper
• Intrinsic and extrinsic risk factors for sagging eyelids.

  2014influential reference
• Central and Peripheral Corneal Thickness Measurement in Normal and Keratoconic Eyes Using Three Corneal Pachymeters

  2014cited by this paper
• Human corneal anatomy redefined: a novel pre-Descemet's layer (Dua's layer).

  2013cited by this paper
• Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes.

  2012cited by this paper
• Correlation of central and peripheral corneal thickness in healthy corneas.

  2012influential reference
• Dry Eye Symptoms and Chemosis Following Blepharoplasty

  2012influential reference
• Master Techniques in Blepharoplasty and Periorbital Rejuvenation

  2011cited by this paper
• Application of visante optical coherence tomography tear meniscus height measurement in the diagnosis of dry eye disease.

  2010cited by this paper
• Corneal epithelial thickness profile in the diagnosis of keratoconus.

  2009cited by this paper
• Diurnal variation of upper and lower tear menisci.

  2008cited by this paper
• Asian Blepharoplasty and the Eyelid Crease

  2007cited by this paper
• Kinetic analysis of tear interference images in aqueous tear deficiency dry eye before and after punctal occlusion.

  2003cited by this paper
• Optical coherence tomography.

  1998cited by this paper
• Effects of ocular surface area and blink rate on tear dynamics.

  1995cited by this paper
• Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography.

  1994cited by this paper

• No citing papers are available for this paper.