The purpose of this chapter is to discuss the risk factors for ptosis surgery failure. Preoperative assessment to patients with marginal reflex distance < 0 mm, poor levator excursion, and preoperative eyelid laxity should be performed. Treatment of eyelid laxity with lateral canthoplasty or full-thickness wedge resection should be performed prior to ptosis surgery. Intraoperative swelling, bleeding, and excessive sedation may negatively influence revision outcome and should be recognized. If significant corneal exposure and lagophthalmos exist postoperatively, early intervention is necessary. If undercorrection exists, surgical revision should be delayed to allow complete resolution of postoperative swelling.
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