Diagnosis and treatment

Treatment for ptosis

What does ptosis surgery involve? 

Ptosis surgery usually involves shortening the muscles or tendons that raise the lid. The muscle or tendon is reattached to your eyelid using sutures, which are buried under the skin. The sutures might be visible on the skin of your eyelids, but are removed around one week after surgery.

Occasionally, the lid is suspended from the brow in order to raise it. This is done using either tendon from your thigh taken via an incision just above the knee, or using an artificial material. Brow lift surgery is often done on both sides at the same time in order to achieve a better cosmetic result. The number of stitches in your leg can vary but this is usually removed after ten to fourteen days. This can be done by your own GP.

 

Does ptosis surgery have any complications?

There is no absolute guarantee of success with any operation and ptosis surgery is no different.

Complications which can occur include

Overcorrection

If your eyelid is overcorrected (too high) after surgery, massaging the lid and pulling it down in a special, controlled manner can be performed to lower the lid. This should only be done if your doctor thinks this may help. Further surgery at a later point might be necessary to lower the eyelid. Ointment is often required at night if your eyes are not closing completely while sleeping.

 

Lid lag

After ptosis surgery, the lid can fail to look down (lid lag). In congenital ptosis, lid lag when looking down is a problem even before surgery, but this might be worse following the operation.

 

Dry eyes

Since proper closure of the eyes is necessary to keep the surface of the eye (cornea) moist, poor eyelid closure will inevitably lead to dry eyes.

This can give the eyes a gritty sensation and make them red, sore and prone to infection. Often, simple lubrication with artificial tears and ointment can help, however if your eyes were already slightly dry before surgery, they might be worse after surgery.

 

Facts and figures

  • About 80- 85% of patients are corrected satisfactorily after the first operation, with asymmetry of 1mm or less.
  • Approximately 15 – 20 % could require a further operation.
  • Complications after ptosis surgery include the eyelid being too high or too low, the curve of the lid being irregular or the upper lid fold of skin being asymmetric. The droopy eyelid can also reoccur at any time in the future and might require a further operation. Repeat surgery such as this can be more complicated to carry out.
  • Bruising of the eyelids and surrounding face is common after ptosis surgery.
  • Bleeding and infection are also potential risks, but are less common.
  • Inability to close the eye after surgery (lagophthalmos) can occur, particularly after large ptosis corrections. This usually corrects itself with time as the muscles relax.
  • Correcting the droopy eyelid on one side can reveal a previously unnoticed droopy eyelid on the other side.

Ptosis treatment is available at Moorfields Private

You can self-fund or use private medical insurance to fund your treatment.

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