Ptosis Surgery (Adult)

Introduction

Ptosis surgery, also known as blepharoptosis surgery, is a surgical procedure to correct drooping of the upper eyelid. The goal of the surgery is to improve vision and appearance by lifting the eyelid to its normal position.

Causes of Ptosis

Ptosis in adults can be caused by a variety of factors, including:

• Aging: Weakening of the muscles that lift the eyelid
• Trauma: Injury to the eye or surrounding tissues
• Neurological disorders: Conditions such as stroke, cerebral palsy, or third nerve palsy
• Tumors: Growths on the eyelid or surrounding tissues
• Previous eye surgery: Complications from previous surgical procedures

Surgical Techniques

There are several surgical techniques used to correct ptosis, including:

• Levator aponeurosis repair: This is the most common technique, which involves tightening the levator aponeurosis muscle that lifts the eyelid.
• Müller's muscle conjunctival resection (MMCR): This technique involves removing a portion of the Müller's muscle and conjunctiva to tighten the eyelid.
• Frontalis sling operation: This technique involves creating a sling using tissue or synthetic material to connect the eyelid to the forehead, allowing the patient to lift the eyelid by raising their eyebrows.
• Tarsoconjunctival flap: This technique involves creating a flap of tissue from the tarsus and conjunctiva to support the eyelid.

Surgical Procedure

The surgical procedure typically involves the following steps:

1. Anesthesia: Local or general anesthesia is administered to numb the area and ensure patient comfort.
2. Incision: A small incision is made in the eyelid crease or conjunctiva to access the underlying tissues.
3. Tissue dissection: The surgeon carefully dissects the tissue to expose the levator aponeurosis muscle or other affected areas.
4. Muscle tightening: The levator aponeurosis muscle is tightened, and any necessary repairs are made to the surrounding tissues.
5. Wound closure: The incision is closed with sutures or staples, and the area is dressed with antibiotic ointment and a bandage.

Postoperative Care

After ptosis surgery, patients typically experience:

• Slight bruising and swelling: This usually resolves within 1-2 weeks
• Pain: Mild to moderate pain that can be managed with over-the-counter medication
• Blurred vision: Temporary blurred vision due to the anesthesia or swelling
• Dry eye: Patients may experience dryness or irritation of the eye, which can be treated with artificial tears

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with ptosis surgery, including:

• Infection: Risk of infection is low, but can occur if the wound becomes contaminated
• Bleeding: Excessive bleeding or hematoma formation
• Asymmetry: Unevenness of the eyelids after surgery
• Dry eye: Persistent dryness or irritation of the eye
• Corneal exposure: Insufficient closure of the eyelid, leading to corneal exposure and potential damage

Recovery Time

The recovery time for ptosis surgery typically ranges from:

• 1-2 weeks: Patients can usually return to normal activities within 1-2 weeks
• 4-6 weeks: Full recovery and resolution of any bruising or swelling usually takes 4-6 weeks

Results

The results of ptosis surgery are typically:

• Improved vision: Correction of the drooping eyelid can improve visual acuity and field of vision
• Enhanced appearance: A more symmetrical and youthful appearance of the eyes
• Increased confidence: Patients often experience improved self-esteem and confidence after surgery