Ptosis is a disorder of the upper eyelid that can develop as you get older and your skin loses elasticity. In people with ptosis, one or both eyelids droops, and in severe cases, the lids can completely cover the pupils and severely impair normal vision. If nonsurgical treatments are no longer giving you the results you need, your optometrist may recommend surgical correction. Here are four things ptosis sufferers need to know about surgical correction.
1. Who should perform surgical correction for ptosis?
Ptosis repair is a delicate surgery, so it's best to have the procedure performed by an oculoplastic surgeon. These specialists have training in both ophthalmology (eye surgery) and plastic surgery, so they're able to safely reshape your drooped eyelids while also giving you an aesthetically pleasing end result. Your optometrist can refer you to a trusted oculoplastic surgeon.
2. What happens during this surgery?
First, your surgeon will measure the excess skin in your upper eyelids to determine how much skin can be safely removed. This is done by pinching the skin with forceps in three or four spots along the eyelids; they will draw markings on your eyelids as they measure.
Your surgeon will make an incision along the crease of your eyelid so that the scar won't be too visible. They will then stitch the tarsus (dense connective tissue within your eyelids) to the aponeurosis (the muscle that holds up your eyelids) together using one to three stitches. These stitches will hold your drooping eyelid in the proper position. Excess skin and fat on your upper eyelids will then be removed, and the incision will be closed. If you have ptosis in both eyelids, the same procedure will then be repeated in the second eyelid.
Like for some other eye surgeries, this procedure is usually performed under local anesthesia. You'll be awake and aware of what's going on, but you won't feel any pain. If you feel very anxious about undergoing eyelid surgery, ask your surgeon if you're a good candidate to have the procedure done under general anesthesia, instead.
3. What complications should you expect?
Dry eye is a possible complication of surgical correction for ptosis. If your eyes are already dry before the surgery, make sure your surgeon knows. They may want to undercorrect your eyelids—not raise them as much as they otherwise would—to prevent your eyes from getting even more dry. If you develop dry eye, you can use over-the-counter artificial tears to keep your eyes comfortable.
Exposure keratitis is another common complication. This complication occurs when your eyelids don't fully cover your eyes when you sleep, allowing your corneas to get dried out. If you develop this complication, your optometrist can prescribe an ointment that will keep your eyes lubricated while you sleep. You may also be told to tape your eyelids shut before you to bed; your optometrist will teach you how to apply the tape safely. Fortunately, this is usually a temporary complication.
4. How effective is this treatment?
Surgical correction for ptosis is very effective and usually provides good results. Studies have reported that this procedure has a success rate of between 80% and 90%, while the other 10% to 20% of patients will require a second surgery to get the results they want. If your eyelids are significantly higher or lower than they should be right after your surgery, your surgeon may be able to open the fresh wounds and perform further repairs before your tissues heal.
If your drooping eyelids are blocking some or all of your vision and nonsurgical treatments aren't helping, ask an ophthalmologist if you're a good candidate for surgical correction. Contact a representative from an establishment like Discover Vision Centers to get started.