Effect of Ptosis Surgery on Tear Oxidative Stress Levels in Patients with Blepharoptosis and Pseudoptosis

Objectives: Investigation of the surgical correction effect on tear film functions and tear oxidative stress levels in patients with blepharoptosis and pseudoptosis. Methods: Sixty patients with blepharoptosis or pseudoptosis due to dermatochalasis and 30 healthy controls were included in the study. Forty eyes underwent upper blepharoplasty and 20 eyes underwent levator surgery. The tear oxidative stress levels (8-hydroxydeoxyguanosine [8-OHdG] and 4-hydroxy-2-nonenal [4-HNE]) were determined by enzyme-linked immunosorbent assay and tear film functions were evaluated pre-operatively and at the post-operative 1st and 6th months. Results: 8-OHdG and 4-HNE levels in tears were found higher in patients with dermatochalasis (86.3 +/- 38.2 ng/mL; 29.8 +/- 11.4 ng/mL, respectively) and blepharoptosis (95.3 +/- 43.8 ng/mL; 40.8 +/- 3.8 ng/mL, respectively) compared to healthy controls (52.9 +/- 14.0 ng/mL; 27.8 +/- 6.6 ng/mL, respectively). Both levels decreased 1 month after blepharoplasty surgery. The 8-OHdG level in tears of patients who underwent levator surgery increased 1 month after the surgery (p=0.008). No change was detected in tear function tests findings between visits in any patient group. Conclusion: Dermatochalasis and blepharoptosis may lead to an increase in the tear oxidative stress levels. Contrary to a decrease in these levels after blepharoplasty, they may increase in the early period after levator surgery followed by a return to normal levels at the 6th-month visit.