After mentioning the majority of potential complications following blepharoplasty, Drs Burke and Wang focus on the adverse clinical outcome of dry eye syndrome. Their article primarily addresses the need for preoperative lacrimal testing.
They state that other factors are more helpful and contributory to blepharoplasty planning than formal tests of lacrimal function. Careful assessment of the orbit and malar anatomy, canthal ligament integrity, and orbicularis/eyelid tone helps predict the risk of postoperative lid malposition and lagophthalmos. On their own, lid malposition problems are significant postblepharoplasty complications; however, they are also common contributors to a postoperative dry eye state. Examination of the periocular anatomy and adnexa provides important clinical information that may prompt adjunct canthopexy and/or canthoplasty to retain proper eyelid function and position following blepharoplasty and thus helps avoid dry eye complications.
Tarbet KJ. Ophthalmic Evaluation Should Be a Preoperative Requirement Prior to Blepharoplasty. Arch Otolaryngol Head Neck Surg. 2001;127(6):723. doi:10.1001/archotol.127.6.723