Clinical Case-control Study of Postoperative Ocular Microbiota Colonization Using Microbial Analysis in Patients Undergoing Blepharoplasty.

Background: Blepharoplasty is the third most common plastic surgical procedure worldwide. However, its impact on the ocular surface microbiota remains unclear. This study aimed to investigate microbial changes before and after blepharoplasty. Methods: A clinical case-control study was conducted involving 30 blepharoplasty patients and 23 controls. Ocular surface swabs were collected, and 16S rRNA sequencing was used to identify bacterial species and abundance. Bioinformatics analysis was performed to annotate and visualize microbial composition. Results: Comparison between groups revealed that patients who underwent blepharoplasty had increased colonization by pathogenic bacteria, whereas controls were primarily colonized by neutral bacteria. Alpha diversity analysis showed a significantly higher bacterial abundance in the surgical group. Beta diversity analysis indicated significant differences in microbial community structure between the 2 groups. Subgroup analysis based on age and sex in the surgical group revealed no significant effects of these factors on microbial composition and abundance. Conclusions: Blepharoplasty may disrupt the ocular mucosal barrier, altering the ocular microenvironment and promoting colonization by pathogenic bacteria. This microbial imbalance may contribute to postoperative ocular discomfort or dysfunction. Notably, age, sex, and surgery frequency did not influence the microbial profile in blepharoplasty patients.