Ptosis Repair

Ptosis Repair

Ptosis (short for blepharoptosis) is a condition where the upper eyelid appears droopy and is unable to open fully. Ptosis is caused by weakness of the levator muscle (levator palpebrae superioris) . In normal situation, the primary function of the levator muscle is to lift the upper eyelid and open the eye. In ptosis, the abnormal levator muscle is unable to lift the upper eyelid properly, causing the upper eyelid to appear droopy, and the eye appears half-opened. Ptosis can occur in both children and adults. If ptosis occur in children, the cause is usually congenital. In adults , ptosis is usually caused by trauma, aging process or disease processes that weaken the levator muscle. Removal of loose skin alone cannot correct ptosis. Ptosis repair is accomplished by repairing and strengthening the levator muscle (levator advancement and levator resection surgery), or in more severe cases, use other muscles to compensate for the weakened levator function (frontalis sling surgery).

Preparation

1. 1. 1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

      2. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.

      3. Stop the following medications and supplements from one week before surgery until one week after surgery.

         1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.

         2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.

      4. On the day of surgery, wear simple and comfortable clothing and do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

      5. Bring a pair of sunglasses on the day of surgery for use after surgery.

      6. Don’t wear contact lenses on the day of surgery.

Surgery

Duration: 1-3 hours, depends on whether unilateral correction or bilateral repairs.

Anaesthesia: Local anaesthesia

Hospitalization: Not required.

Recovery*: Back to work in 3-7 days, light exercise after 7-14 days, heavy exercise after 3-4weeks. * The actual speed of recovery may vary from person to person.

Surgery Technique: Levator advancement surgery: The surgeon makes a standard upper blepharoplasty incision to gain access to the upper eyelid. The aim of the surgery is to identify and repair and tighten the abnormal levator muscle. The exact surgical technique depends on the ptosis severity and the existing condition of the levator muscle.

Post-operative Care**

1. 1. 1. What to expect: Swelling usually peaks on the second to third day after surgery and will gradually subside after that. Post-operative pain is usually minimal.

      2. General care:

         1. Apply the cold pack in the first 3 days and then the warm pack in the following 3 days. Elevate the head during sleep to reduce swelling.

         2. Avoid smoking for at least one month. Smoking increases the risk of wound complications.

         3. Use sunglasses for protection when going outdoors.

         4. Good rest and adequate sleep are helpful for a speedy recovery.

         5. Be relaxed and calm. Contact the clinic if there are any queries.

         6. Don’t use contact lenses for at least 4 weeks.

      3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.

      4. Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment. No wound dressings are required.

      5. Physical activity: Avoid heavy physical activities and exercises for at least one month.

      6. Follow-up: Come back one week after surgery for suture removal and review.

      7. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, contact the clinic/doctor for advice immediately.

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.