Ptosis Repair

Ptosis repair:

Ptosis is defined as grouping up the depth of the upper eyelid partially covering the pupil. Ptosis causes a droopy or sleepy appearance and reduces vision. Repair is intended to provide a more youthful and vibrant appearance as well as improve your site.   Some patients with ptosis also have excess skin and fat in the upper lid which can be corrected at the same time as the ptosis repair

Ptosis repair is best performed by a surgeon who specializes in eyelid surgery such as a plastic surgeon, which requires extensive experience. Care is needed in planning and performing this surgery. Special training is also required in order to ensure proper lubrication of the eye after surgery.

Causes of Ptosis

Involutional – In most people, ptosis is caused by the gradual stretching of the tissue which supports the upper eyelid. Involutional ptosis usually occurs with aging.  In addition to long-term rigid contact lenses which may weaken that issue of the upper eyelid, it can be corrected by tightening the levator muscle. The function of the levator muscle is to raise the eyelid. Ptosis repairs are performed through an incision in the normal creases of the upper eyelid.

Muscular ptosis– In some people, ptosis is caused by a week leave a little muscle the function of the leave after the muscle is to raise the eyelid muscle ptosis can occur in early childhood or adulthood.

Ptosis which occurs in early childhood is usually due to a weak levator muscle.

If the ptosis affects the child’s vision, early correction is necessary. In some cases, the ptosis will keep the child from walking well because the child must lift the chin in order to see. If the ptosis is not severe the repair is delayed until the child is older.

Muscular ptosis can also be acquired later in life as muscles weaken in some cases is associated with muscular or neurological problems.

If some muscular function remains in the levator, muscular ptosis is corrected by tightening the levator muscle. This is called a levator resection. When the muscle is first tightened you will not blink normally.  This may result in dryness of the eye. At first, you will need to frequently lubricate your eye with ointment or drops in order to keep it from drying out. In time you will be able to close the eye normally.

If your levator muscle is very weak, tightening the muscle will not adequately raise the lid. In that case, a frontalis suspension is necessary. During a frontalis suspension, small strands are placed between the eyelid and eyebrow. These strands are tightened in order to raise the lid. When you wish to raise your eyelid, you will unconsciously raise your eyebrows. When you want to close your eyelids, you will unconsciously lower your brows and squeeze your eyelids shut.

In most adults a frontalis suspension is performed with an elastic strand of solid silicone a solid silicone strand is more elastic than a fibrous tissue used in children, making it easier to close your eyelids after the procedure. In addition, using Silicon is safer because the eyelid height may easily be lower if your eye is drying out and cannot tolerate the higher position of the eyelids

After Surgery

After surgery your eyelid will be swollen in your vision blurry .it is important to elevate your head and use cold compresses as much as possible to reduce swelling. If swelling is excessive it could stretch and create a tear in the sutures.

After surgery, the operated eyelid will be stiffer than normal. When you go to sleep if your facial muscles relax your eyelid will tend to open. In general, the weaker the lifting the muscle was before the surgery, the more stiffness will be produced by surgery. However, it is necessary to use lubricating ointment and drops to prevent dryness. In most people, these lubricants will be needed for a few weeks after surgery.

Some people are at risk of serious dry eyes. This may occur in people who already have dry eye syndrome.

A doctor visit one week after surgery will be needed to ensure that the eye is adequately lubricated. You will need to see the doctor regularly after the surgery until the eyelid is closing well.

Adjustment

Unfortunately, ptosis repair is not an exact science. The final position of the eyelid depends on the healing of the tissue. In some cases, later adjustment is necessary if the eyelid is clearly too high or too low at the first visit the wound is gently opened in the office and the eyelid height readjusted.

Other times the adjustment may be performed several months after surgery if the eyelid height is not appropriate. Performing adjustment after that issue has been healed requires a second surgery.

Contact lens wear

You may wear your contact lenses when your eyelid is closing well. Most people begin wearing lenses again about 3 to 4 weeks after surgery.