Purpose: Assess predisposing risk factors and discuss prevention and treatment of dry eye syndrome after blepharoplasty.

Background: Dry eye syndrome is an expected sequela after blepharoplasty. In some patients this may persist to become a chronic problem. Identifying high risk patients before surgery and perioperative preventive management is essential for the surgeon to avoid long term morbidity.

Methods: A retrospective review of 200 consecutive patients who had upper and/or lower blepharoplasties is performed with particular attention to the occurrence of dry eyes and its management.

Results:

• Dry eyes persisting for longer than two weeks occurred in 22 (10.8%) patients.

• Four (1.9%) patients eventually required referral to an ophthalmologist

• One (0.5%) needed surgical correction of lid retraction

• The remaining patients resolved with conservative management including artificial tears, lubrication, topical and systemic steroids and night taping.

• Persistent chemosis was associated with 68% of patients (p<0.01) who had symptomatic dry eyes lasting more than two weeks after surgery

Conclusions: Preoperative recognition, intraoperative prevention and postoperative management of patients undergoing upper or lower blepharoplasty are essential in minimizing the occurrence of persistent dry eye syndrome.