Corneal topographic changes after upper eyelid blepharoplasty prior to cataract surgery

Abstract Purpose To investigate the effect of upper eyelid blepharoplasty (UEB) on corneal topography in cataract patients using Scheimpflug technology. Methods This prospective single-center, longitudinal study included 88 eyes of 45 patients undergoing UEB for dermatochalasis prior to cataract surgery. Scheimpflug imaging (Pentacam®AXL, Wetzlar), was performed preoperatively and at two weeks and three months postoperatively. The primary outcome was change in corneal astigmatism, assessed as the cylindrical component of total corneal refractive power (TCRP). Secondary outcomes included K1, K2, Kmax, Km, astigmatism axis and anterior chamber depth (ACD), front and back Keratometry (FK, BK). Results The mean age of 67.0 ± 8.7 years; 67% of patients were female (n = 30) and 33% male (n = 15). At three-months, statistically significant changes were observed in cylindrical TCRP (P = 0.010), K1 ( P = 0.023), and ACD ( P = 0.007). Additionally, FK2 showed a statistically significant change at 2 weeks ( P = 0.021) but not at three-months. F-KMax and BKm were not significantly changed at 2 weeks, but showed statistically significant changes at three-months follow-up ( P = 0.043 and P = 0.010 respectively). Conclusion UEB was associated with minor changes in selected corneal topographic parameters and ACD. Although some changes reached statistical significance, their clinical relevance was not established. Repeat corneal measurements after UEB may be considered before cataract or refractive surgery when precise refractive outcomes are intended. These findings do not establish a specific three-month waiting period or demonstrate an effect on intraocular lens (IOL) power calculations or final refractive outcomes.