Effect of Upper Eyelid Blepharoplasty on Meibomian Gland Morphology

INTRODUCTION: To assess changes in tear film parameters and meibomian gland (MG) morphology after upper eyelid blepharoplasty. METHODS: This prospective observational study included 58 eyes from 29 patients who underwent upper eyelid blepharoplasty. Noninvasive tear break-up time (NITBUT) and MG morphology were evaluated for all patients. Patients were assessed before surgery and three months postoperatively. RESULTS: The mean percentage of MG dropout showed a significant increase in the postoperative period (p < 0.001). Morphological assessment revealed a significant increase in MG shortening scores at postoperative month three (p = 0.014), whereas distortion scores, dropout scores, and total meiboscore did not differ significantly between the preoperative and postoperative evaluations. No statistically significant differences were observed in the first NITBUT or average NITBUT values at three months after surgery compared with preoperative measurements. DISCUSSION AND CONCLUSION: Upper eyelid blepharoplasty may lead to mild and localized alterations in MG morphology, particularly characterized by gland shortening and a modest increase in gland dropout area. However, tear film stability, as assessed by non-invasive methods, remains largely unaffected within the three-month postoperative period. Upper eyelid blepharoplasty is generally safe in terms of MG integrity and tear film dynamics, although longer-term studies are needed to clarify the persistence of these changes.