Global injury associated with blepharoplasty is rare but serious, study suggests

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Blepharoplasty is a frequently performed ophthalmic surgery. As with any procedure, even the commonly performed ones, there are associated adverse events. For blepharoplasty, these include infection, bleeding, and excessive or incomplete fat removal among others.

First author Benjamin Meyer, MD, and colleagues reported that global injuries, although rare, also can occur and urged that they be addressed promptly.¹ He is from the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami.

In this study, the authors reported a case series and literature review with a total of 16 cases of global injury following blepharoplasty.

The investigators found that the injuries ranged from deep thermal burns to full-thickness corneal or scleral lacerations, with 1 case of traumatic cataract.

“The median time from surgery to symptom onset was 1 day, with a concerning median delay of 7 days to presentation to an ophthalmologist. Visual outcomes were generally poor, with nearly all patients experiencing permanent visual morbidity,” they reported.

In addition, endophthalmitis developed in 3 cases that were reported in the systemic review that occurred following perforating scleral injuries.

A comparison of penetrating and perforating injuries showed no differences in the visual outcomes.

Meyer and colleagues called for increased vigilance for globe injuries that require prompt ophthalmologic evaluation following blepharoplasty. They especially emphasized the delayed presentation and the degree of the visual morbidity

“The study advocates for improved practitioner training in recognizing and managing these complications and underscores the importance of patient education regarding the potential risks and the necessity of timely postoperative care,” they concluded.

Reference:

1. Meyer BI, Shoji MK, Zamani KA, et al. Beyond the surface: a systematic review of perforating and penetrating globe injuries from blepharoplasty. Ophthal Plast Recons. 2024;40:374-379;DOI: 10.1097/IOP.0000000000002625