Amaç: Üst ve alt lakrimal drenaj sistemi (LDS) tıkanıklığı olan olgularda preoperatif kan testlerinden sistemik inflamasyon belirteçlerini araştırmak ve gruplar arasında bu inflamatuar belirteçleri ve uygulanan cerrahi tedavilerin başarısını karşılaştırmak amaçlandı. Gereç ve Yöntemler: Bu retrospektif çalışmada 2021-2023 yılları arasında LDS tıkanıklığı olan olguların dosyaları incelendi. Üst LDS tıkanıklığı olan olgular Grup 1'e ve alt LDS tıkanıklığı olan olgular Grup 2'ye dahil edildi. Tüm hastaların ameliyat öncesi tam kan sayımından, sistemik inflamatuar belirteçler olan nötrofil-lenfosit oranı (NLR), platelet-lenfosit oranı (PLR) ve ortalama platelet hacmi (MPV) elde edildi. Nötrofil (N), lenfosit (L) ve platelet (P) sayılarına (NxP/L) dayanan sistemik immün inflamasyon indeksi (SII) bir biyobelirteç olarak hesaplandı. Her iki grubun sistemik inflamasyon belirteçleri ve cerrahi tedavi başarısı karşılaştırıldı. Bulgular: Çalışmaya 46 (Grup 1=26, Grup 2=20) olgunun 57 (Grup 1= 37, Grup 2=20) gözü dahil edildi. Grup 1'deki olguların yaş ortalaması 52,3±9,4 yıl iken; Grup 2'de 47,1±9,0 yıl idi (p=0,067). Cinsiyet dağılımı Grup 1’de 18 kadın, 8 erkek; Grup 2’de 15 kadın 5 erkek idi (p=0,749). Grup 1'de ortalama nötrofil sayısı 4,98±2,36 10^3/uL, NLR 2,25±1,19 ve PLR 114,7±29,2 idi. Bu değerler Grup 2'de sırasıyla 3,91±0,85 10^3/uL, 1,57±0,48 ve 95,5±27,9 idi (p

The role and prognostic significance of systemic inflammatory markers in various malignancies have been the subject of investigation. The role of these inflammatory markers in eyelid lesions remains to be elucidated. Benign and malignant lesions of the eyelid are common presentations in eye clinics. Systemic inflammatory markers derived from a complete blood count may provide insight into the benign-malignant differentiation of the lesion. This study included 134 patients who underwent surgery for eyelid lesions between 2021-2023. The lesions were evaluated by oculoplastic surgeons and operated on with a preliminary diagnosis of benign or malignant. According to the histopathological diagnosis, benign lesions were included in Group 1 and malignant lesions in Group 2. The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII) (NxP/L) based on neutrophil, lymphocyte, and platelet counts were calculated from the preoperative complete blood count of all patients. Eighty-eight patients were included in Group 1 and 46 patients in Group 2. There were 41/47 (Female/Male) in Group 1 and 19/27 (F/M) males in Group 2 (p = 0.345). The mean age was 62.91 ± 9.04 years in Group 1 and 65.41 ± 8.76 years in Group 2 (p = 0.127). The preliminary diagnosis and histopathological diagnosis were incompatible in 5 cases in both groups. In Group 1: NLR = 1.82 ± 0.72, PLR = 124.50 ± 45.19 and SII = 454.51 ± 220.20, in Group 2: NLR = 2.48 ± 0.89, PLR = 128.12 ± 49.58 and SII = 590.22 ± 271.09. NLR and SII differences between groups were statistically significant, while PLR was similar (p < 0.001, p = .002, p = .671). ROC curve analysis showed that the optimal cut-off values for NLR, PLR, and SII were 1.99, 119.16, and 475.21, respectively. High levels of NLR and SII in eyelid tumours can be used as an adjunct to examination findings in the preliminary diagnosis of the lesion as benign or malignant and may influence surgical planning.

Background/Objectives: To evaluate margin reflex distance-1 (MRD-1), inter-eyelid symmetry, functional visual parameters, and cosmetic outcomes following Müller Muscle–Conjunctival Resection (MMCR) in selected pediatric patients with mild-to-moderate blepharoptosis, good levator function, and a positive 2.5% phenylephrine test. Methods: This retrospective observational study included pediatric patients (<18 years) who underwent MMCR between 2018 and 2023. Surgical indications were based on functional or developmental criteria, including visual axis obstruction, abnormal head posture, significant eyelid asymmetry, or psychosocial concerns, rather than eyelid height alone. Preoperative and postoperative examinations at 1 week, and at 1, 3, and 6 months, included best-corrected visual acuity (BCVA), MRD-1, eyelid symmetry, levator function, lagophthalmos, and ocular surface findings. Outcomes were analyzed separately for unilateral and bilateral cases. Statistical analyses were performed using non parametric tests, with p < 0.05 considered statistically significant. Results: Fifty patients (55 eyes; mean age 13.16 ± 4.04 years) were included. Mean preoperative MRD-1 increased significantly from 1.83 ± 0.89 mm to 2.97 ± 0.83 mm at 6 months (p < 0.001). Postoperative MRD-1 at 6 months showed a significant correlation with the phenylephrine response. In unilateral cases, excellent or satisfactory postoperative symmetry was achieved in 83.6% of eyes. Bilateral cases demonstrated comparable MRD-1 elevation with satisfactory contour and high patient/parent satisfaction. Transient lagophthalmos improved over time. No overcorrection, exposure keratopathy, or significant ocular surface complications were observed. Revision surgery was required in 8.9% of unilateral cases. Conclusions: MMCR is a safe and effective option for appropriately selected pediatric patients, providing predictable eyelid elevation, good symmetry, and low complication rates when functional indications are present.

Objective: To evaluate the effect of Müller Muscle–Conjunctival Resection (MMCR) on pupil diameter under different lighting conditions and to evaluate whether MMCR is associated with measurable postoperative changes in pupil diameter under different lighting conditions in patients with blepharoptosis.Material and Methods: This retrospective clinical study included 34 eyes of 34 patients who underwent MMCR for mild-to-moderate ptosis with good levator function and a positive phenylephrine test. All surgeries were performed by a single experienced surgeon. Preoperative and postoperative (1 and 3 months) assessments included margin reflex distance-1 (MRD-1), comprehensive ophthalmic examination, and static pupillometry using an infrared-based device. Scotopic (0.04 lux), mesopic (4.0 lux), and photopic (40.0 lux) pupil diameters were recorded under standardized environmental conditions. Repeated measurements were analyzed using the Friedman test with Bonferroni-corrected post hoc comparisons. A p value < 0.05 was considered statistically significant.Results: The present study comprised 34 eyes from 34 patients, predominantly female (59%), with 20 (59%) of the patients undergoing right eyelid surgery and 14 (41%) undergoing left eyelid surgery. The etiology of ptosis was categorized as follows: congenital ptosis, 28 patients (82%); involutional ptosis, 4 patients (12%); and neurogenic ptosis, 2 patients (6%). The mean patient age was 30.82 ± 11.92 years. Mean levator function was 16.05 ± 2.32 mm. MRD-1 increased significantly from 2.35 ± 0.19 mm preoperatively to 3.52 ± 0.17 mm at 1 month and 3.82 ± 0.15 mm at 3 months postoperatively (p < 0.001). In contrast, no statistically significant differences were observed between preoperative and postoperative scotopic, mesopic, or photopic pupil diameters at any time point (all p> 0.05). No clinically relevant pupillary abnormalities or ocular surface complications were detected. One eyelid with inadequate correction underwent subsequent levator surgery. Conclusions: MMCR significantly improved eyelid height without detectable statistically significant changes in pupil diameter under varying lighting conditions. These findings may have implications for the surgical outcomes of refractive and ptosis surgeries. However, further prospective studies with larger patient populations are required to confirm these observations.