Does upper lid blepharoplasty improve contrast sensitivity?

Purpose: To assess the effect of upper eyelid blepharoplasty surgery on contrast sensitivity.

Methods: A prospective study was performed. Pre- and postoperative contrast sensitivity measurements were taken on patients undergoing routine upper eyelid blepharoplasty surgery. The patients were selected for surgery on the basis of a functional visual field effect from dermatochalasis. Contrast sensitivity was measured using a Pelli-Robson chart, read at 1 m under standard lighting conditions. This produces a result in log contrast sensitivity. Other data collected included visual acuity and an automated 60:4 visual field. A paired t test was used to assess the change in contrast sensitivity.

Results: 28 eyes of 14 patients underwent upper eyelid blepharoplasty surgery. The mean preoperative log contrast sensitivity was 1.49, and the mean postoperative log contrast sensitivity was 1.64. The mean increase in log contrast sensitivity was 0.14 (range 0-0.45). The increase in log contrast sensitivity was statistically significant (p = 0.00002).

Conclusions: Dermatochalasis is well known to cause visual field defects in many patients. Anecdotally, patients often report that their vision is brighter following upper eyelid blepharoplasty. The authors have demonstrated a significant increase in contrast sensitivity in patients who have undergone upper eyelid blepharoplasty surgery. This information may be of use in justifying blepharoplasty surgery in the future.