Effect of Upper Eyelid Surgery on Vision and Corneal Topographic Changes Measured by Pentacam

Background: Ptosis, dermatochalasis, and eyelid surgeries can exert pressure on the cornea, inducing surface reshaping and topographic alterations measurable with imaging technologies.
Objective: To compare the effects of upper eyelid surgery on visual acuity and corneal topography using Pentacam.
Patients and Methods: In this prospective study, 20 eyes from 12 patients with ptosis or dermatochalasis underwent corrective surgery. Ophthalmic examination and Pentacam corneal topography were performed preoperatively, and repeated at 1 and 3 months. Parameters included K1, K2, KM, corneal astigmatism, and central corneal thickness (CCT). Best-corrected visual acuity (BCVA) was also assessed.
Results: At 1 month, mean BCVA showed a significant but temporary change (p = 0.001), which was absent at 3 months (p = 1.000). Corneal astigmatism demonstrated a transient myopic shift of 0.2 D (p = 0.001) with axis change (p = 0.034) at 1 month; both were non-significant at 3 months (p = 0.119 and p = 0.342). Mean K1 and KM showed no differences at 1 month (p = 1.000), while K2 differed significantly (p = 0.001). At 3 months, significant differences were found in K1 (p = 0.017) and KM (p = 0.001), but not K2 (p = 0.173). CCT showed a transient 1-month change (p = 0.034), returning to baseline at 3 months (p = 1.000).
Conclusion: Ptosis and dermatochalasis impose chronic corneal pressure, producing measurable topographic alterations. Surgical correction relieves this pressure, inducing short-term astigmatic changes that normalize within 3 months, while effects on BCVA remain clinically negligible.