The Impact of Full-Incision Double-Eyelid Blepharoplasty on Dry Eye: Association with Short-Term Meibomian Gland Dysfunction and Increased Incomplete Blinking

This study aims to comprehensively evaluate the short-term changes in ocular surface parameters and meibomian gland function following Full-incision double-eyelid blepharoplast.

In this observational self-controlled study, 50 patients (100 eyes) undergoing full-incision double-eyelid blepharoplasty were enrolled. Assessments were conducted preoperatively and at 1 week, 1 month, and 3 months postoperatively. These included the Ocular Surface Disease Index (OSDI) questionnaire, fluorescein tear film break-up time (FBUT), corneal fluorescein staining (CFS), Schirmer I test, meibum quality, meibomian gland expressibility, meibomian gland dropout (excluding 1-week), lipid layer thickness (LLT), and incomplete blinking rate (IBR). Statistical comparisons were performed using ANOVA with post-hoc analysis.

Compared to baseline, OSDI scores, meibum quality, meibomian gland expressibility, and IBR showed statistically significant deterioration at both 1 week and 1 month post-surgery (all p < 0.001). In contrast, no significant changes were observed in FBUT, CFS, Schirmer I test, LLT, or meibomian gland dropout at any time point. By the 3-month follow-up, all significantly altered parameters—OSDI, meibum quality, expressibility, and IBR—had recovered to levels that were not statistically different from preoperative baseline values.

Full-incision double-eyelid blepharoplasty induces a transient but significant dysfunction of the ocular surface and meibomian glands in the early postoperative period, which is closely associated with a sharp increase in incomplete blinking. These findings underscore the importance of proactive postoperative management, including dry eye counseling, artificial tears, and blink training, to enhance patient comfort during the recovery phase.

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