*HOT TOPIC*

Authors: Anne X. L. Nguyen¹, Victoria C. Leung², Fares Antaki², Isabelle Hardy², Rafic Antonios³, Patrick R. Boulos².

Authors Disclosure Block: A.X.L. Nguyen: None. V.C. Leung: None. F. Antaki: None. I. Hardy: None. R. Antonios: None. P.R. Boulos: None.

Abstract Body:

Purpose: To evaluate perceptions of blade versus laser-based blepharoplasty before and after being provided educational information about the procedures
Study Design: Interventional pre-post study
Methods: Study participants were recruited at the University of Montreal’s Centre universitaire d’ophtalmologie in August 2020. Participants were presented with a definition of blepharoplasty and photos of patients pre- and post-blepharoplasty. They answered 12 questions assessing their perceptions about blepharoplasty. They then received educational information regarding the similarities and differences between the techniques before answering final questions.
Results: A total of 145 participants (51% M, 49% F, mean age: 61) completed the survey. Only 9% of participants had previously received information on blepharoplasty, and 8% had undergone a prior cosmetic procedure. Participants’ perception about surgical outcome was significantly altered pre- and post-intervention (p<0.001). Pre-intervention, 58 (40%) participants selected laser to have better outcomes, with 69% of these maintaining their preference post-intervention. Among 54 (37%) participants selecting blade pre-intervention, 51% switched to laser post-intervention. Pre-intervention, 33 (23%) considered the techniques similar. Despite information provided to participants clearly stated that both techniques offer the same esthetic result, only 60 (41%) considered the two techniques similar post-intervention, as 81 (56%) perceived laser to have the better outcome and 4 (3%) blade. Perception also changed pre- and post-intervention when asked about the technique they would choose if undergoing blepharoplasty (p<0.001). Amongst 93 (64%) participants who initially favored laser, 90% chose blade post-intervention. In contrast, among 29 (20%) participants who initially favored blade, 66% continued to prefer blade post-intervention. 23 (16%) considered the techniques similar. After the intervention, the trend evolved: 118 (81%) preferred blade, 17 (12%) laser, and only 10 (7%) had no preference as they considered the techniques similar.The pre-intervention perception of blade’s recovery time was longer than laser’s (20.1 > 13.5 days; p=0.01). Perceived recovery time increased for both blade (36.6 days) and laser (17.9 days) post-intervention (p<0.001). When comparing laser versus blade, most participants perceived them to have the same longevity (45%: 5-10 years), level of risk (52%: mild) and reversibility of results (44%: irreversible). 55% perceived blade to be more invasive. Perceived pain and technical difficulty were lower for laser than blade. Participants believed that an average difference of $975 would justify laser compared to blade.

Conclusions: Statistically significant changes in perceived surgical outcome, preferred surgical technique, and anticipated recovery time suggest that patients are impacted by counseling. Imperfect recall suggests that patients would benefit from better communication approaches: visual aids, repeated questioning, tailored communication styles. Interestingly, post-intervention, while the majority of our study participants (56%) identified laser to have a better outcome, most (81%) still stated they would select blade-based surgery. One explanation for this discrepancy could be cost considerations.