Risk factors for early eyelid swelling following blepharoptosis surgery: A retrospective study.

Background: Postoperative swelling of the eyelids surgery can cause discomfort and reduce patient satisfaction. This study is a retrospective analysis of factors associated with early postoperative swelling after blepharoptosis surgery. Methods: The study included 105 patients who underwent primary bilateral ptosis surgery performed by the same plastic surgeon between April 2020 and December 2022. Aponeurotic repair, excess skin removal and lateral horn release were performed as needed, depending on the clinical findings in each case. Postoperative swelling was rated on a four-point scale: 0 (no swelling), 1 (mild), 2 (moderate), and 3 (severe). Results: Postoperative swelling was significantly correlated in patients with a larger width of skin excision, diabetes, aging, hypertension, high intraoperative systolic blood pressure, and longer surgery duration. Detailed examination showed that the length of aponeurosis advancement and changes in margin reflex distance (MRD) did not significantly affect swelling. Conclusions: Starling's law is important to consider in preventing postoperative swelling, as it explains which factors contribute to edema. Surgical manipulation also triggers factors that cause swelling. Bleeding, inflammation, and lymphatic damage further exacerbate swelling. Knowing the risk factors for swelling in advance helps predict postoperative outcomes and helps inform patients, which may also improve postoperative management. Future studies using multivariate analysis are expected to provide valuable insights into preventing and managing postoperative eyelid swelling.