title: Blepharoplasty in the post-laser in situ keratomileusis patient: preoperative considerations to avoid dry eye syndrome.
abstract: BACKGROUND
  The authors used a retrospective case series to describe the increased frequency of dry eye syndrome in patients who have undergone both laser in situ keratomileusis and blepharoplasty.
  
  
  METHODS
  The authors reviewed records from six patients who required surgical correction for exposure keratopathy previously treated by both laser in situ keratomileusis and blepharoplasty.
  
  
  RESULTS
  All six patients developed significant exposure keratopathy postoperatively requiring surgical intervention. Four patients had blepharoplasty followed by laser in situ keratomileusis, and two patients had laser in situ keratomileusis followed by blepharoplasty. Symptomatic dry eye symptoms followed the second procedure 1 week to 4 months later. Surgical correction of eyelid malposition and lagophthalmos markedly improved symptoms.
  
  
  CONCLUSIONS
  Patients with a history of laser in situ keratomileusis contemplating blepharoplasty are at higher risk of developing postoperative dry eye syndrome. Surgeons performing these procedures should perform thorough preoperative evaluation and surgical planning to minimize this potential complication.
authors.affiliation: La Jolla, Calif From the Divisions of Ophthalmic Plastic and Reconstructive Surgery and Cornea and Keratorefractive Surgery, Department of Ophthalmology, University of California, San Diego School of Medicine.
authors.forename: Bobby S
authors.initials: BS
authors.lastname: Korn
authors.forename: Don O
authors.initials: DO
authors.lastname: Kikkawa
authors.forename: David J
authors.initials: DJ
authors.lastname: Schanzlin
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000009:adverse effects*; D015352:Dry Eye Syndromes / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies