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Purpose: To compare the aesthetic outcomes of the upper blepharoplasty with or without resection of the preseptal orbicularis oculi muscle., Methods: An interventional randomized double-blind left-right study was conducted in 15 consecutive patients with dermatochalasis of the upper eyelid. One side was randomly chosen for resection of the preseptal orbicularis oculi muscle (group 1). The orbicularis oculi muscle of the contralateral side was preserved (group 2). All patients scored differences between both sides on the seventh day, the thirtieth day, and the ninetieth day after the surgery regarding the following symptoms: edema, hematoma, itching, and pain. Three masked ophthalmic plastic specialists analyzed the aesthetic outcomes by the visual analogical scale., Results: The scoring of symptoms was significantly higher in group 1 than in group 2 on the seventh postoperative day. On the thirtieth and ninetieth days, there were no significant differences between groups 1 and 2. The analysis by 3 masked observers showed that the aesthetic result was worse in group 1 than in group 2 on the seventh postoperative day. There were no significant differences between groups 1 and 2 on the thirtieth and ninetieth days., Conclusions: Upper blepharoplasty causes more postoperative symptoms and presents worse initial aesthetic outcome when the preseptal orbicularis oculi muscle is excised. However, the final aesthetic outcome is the same when the preseptal orbicularis oculi muscle is excised or preserved.

Purposes: To evaluate the importance of objective examinations together with ocular history and orbital and periorbital anatomy, to identifying patients at risk of developing a post-blepharoplasty dry eye complication., Methods: A prospective study was performed on 29 patients with dermatochalasis that were studied before and three months after blepharoplasty. Changes in ocular symptoms, physical examination and in objective tests, like Schirmer's test, tear film break-up time and rose bengal coloration were evaluated., Results: No statistical significant alteration in results of objective tests, except Schirmer II test, between pre and postoperative period were found. In relation to eyelid anatomy, alterations in palpebral fissure and in excursion of the upper eyelid, that were statistically significant were found after surgery., Conclusions: It may be stated that palpebral fissure alterations occur frequently in patients submitted to esthetic blepharoplasty. It is also possible to conclude, that in this study, the objective tests for dry eye evaluation, did not demonstrate significant postoperative alterations, except for Schirmer II test.

Ectropion is characterized by the eversion of the eyelid margin and the consequent exposure of the conjunctiva and cornea. The shortening of the anterior lamella of the lid causes cicatricial ectropion. We described a case of skin pathology causing cicatricial ectropion. The case is about a 68-year-old woman with a 2-year history of psoriatic arthritis. She complained of eyelid tearing and redness for two years. Due to the psoriasis, she presented a very dry skin, also in the periocular region, resulting in cicatricial ectropion. A skin graft was indicated to correct the eyelid malposition. Careful investigation should be performed in patients who have a skin disease that can lead to cicatricial ectropion. [ABSTRACT FROM AUTHOR]