Journal of the Korean Ophthalmological Society 2006;47(7):1031-1036.
Published online July 31, 2006.
The Changes in Tear Film and Ocular Surface Associated with Lagophthalmos after Frontalis Suspension.
Jin Sook Yoon, Young Wook Kim, Sang Yeul Lee
The Institute of Vision Research, Department of Ophthalmology Yonsei University College of Medicine, Seoul, Korea. sylee@yumc.yonsei.ac.kr
이마근 걸기술후 토안으로 인한 눈물막 및 안구표면의 변화
윤진숙,김영욱,이상렬
The Institute of Vision Research, Department of Ophthalmology Yonsei University College of Medicine, Seoul, Korea
Correspondence:  Jin Sook Yoon, M.D.
Abstract
PURPOSE
We investigated the incidence of exposure keratopathy, cornea protective changes in tear film such as corneal sensitivity, tear film stability, and tear secretion after frontalis suspension, and the correlation of these with lagophthalmos. METHODS: The corneal sensitivity test, tear film break-up time (tBUT) measurement, and basic secretion test were performed prospectively in patients who had undergone frontalis suspension. RESULTS: The mean lagophthalmos was highest at postoperative 1 week and then gradually decreased. There were no significant changes in corneal sensitivity, tBUT or tear secretion after surgery. No significant differences were found in those parameters between eyes with lagophthalmos of 3 mm or more and those less than 3 mm, nor did these parameters differ between eyes with clear cornea and exposure keratopathy. Only tBUT at postoperative 1 week was significantly shorter in eyes with lagophthalmos 3 mm or more than those less than 3 mm. The average level of lagophthalmos in eyes with exposure keratopathy (15/33 eyes, 45.4%) was more than 3mm at every follow-up period, which was significantly higher than for eyes with a clear cornea. CONCLUSIONS: Tear physiology tends to maintain normal function despite poor blinking induced by lagophthalmos. The cornea is thought to be protected by these functions of tear film. The factor most influential on cornea status was the level of lagophthalmos, and exposure keratopathy should be carefully examined during postoperative period in eyes with higher lagophthalmos, especially more than 3 mm.
Key Words: Exposure keratophathy;Frontalis suspension;Lagophthalmos;Tear physiology


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