Surgical Techniques to Lower Post-Bleph Dry Eye Risk

At the 2020 American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) virtual meeting, Stephen Perkins, MD, facial plastic surgeon, Meridian Plastic Surgery Center, Indianapolis, Ind., discussed the blepharoplasty techniques he uses to best minimize the risks of exacerbated dry eye syndrome post-procedure.

In his presentation, “Dry Eye Syndrome After Blepharoplasty with Treatment Alternatives for Severe Chemosis,” Dr. Perkins explains that in 60% of his cases, he takes the fat that bulges medially and nasally under the eye and creates a pocket to place it under the orbicularis and on top of the periosteum to fill the nasal trough. He says that this is easier to do transcutaneously. While he also does this technique transconjunctivally, he says that it can increase the incidence of dry eye syndrome due to the extra manipulation of the tissue. The orbicularis suspension suture to the lateral periosteum can also create more of a risk for conjunctival chemosis due to lymphatic blockage.