Ptosis repair is one of the most common operations in oculofacial plastic surgery. In mild cases, eyelid ptosis can be purely cosmetic, but in severe cases, it can cause significant visual field compromise, hindering vision and resulting in amblyopia in children. Because a variety of mechanisms can cause ptosis, it is essential that the surgeon make the proper diagnosis and implement the right surgical plan to achieve the best result. Even in expert hands, however, a less than ideal result can occur. Variables exist beyond the surgeon’s control, but it is the proper recognition and management of these problems that allow for optimized outcomes even in the face of complications.
This chapter details the most frequent complications associated with the different approaches to ptosis surgery. These include: under/overcorrection, lid contour abnormalities, lid malposition, and lagophthalmos. Recommended medical and surgical solutions to deal with each specific postoperative complication are also covered.
Contour Deformity Frontalis Suspension Orbital Septum Levator Function Tarsal Plate
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Cetinkaya A, Brannan PA. Ptosis repair options and algorithm. Curr Opin Ophthalmol. 2008;9(5):428–34.CrossRefGoogle Scholar
Spahiu K, Spahiu L, Dida E. Choice of surgical procedure for ptosis correction. Med Arh. 2008;62(5–6):283–4.PubMedGoogle Scholar
Ahmad SM, Della Rocca RC. Blepharoptosis: evaluation, techniques, and complications. Facial Plast Surg. 2007;23(3):203–15.CrossRefPubMedGoogle Scholar
Whitehouse GM, Grigg JR, Martin FJ. Congenital ptosis: results of surgical management. Aust N Z J Ophthalmol. 1995;23(4):309–14.CrossRefPubMedGoogle Scholar
Cates CA, Tyers AG. Outcomes of anterior levator resection in congenital blepharoptosis. Eye. 2001;15 (Pt 6):770–3.PubMedGoogle Scholar
Dortzbach RK, Kronish JW. Early revision in the office for adults after unsatisfactory blepharoptosis correction. Am J Ophthalmol. 1993;115(1):68–75.PubMedGoogle Scholar
Lee MJ, Oh JY, Choung HK, Kim NJ, Sung MS, Khwarg SI. Frontalis sling operation using silicone rod compared with preserved fascia lata for congenital ptosis a three-year follow-up study. Ophthalmology. 2009;116(1):123–9.CrossRefPubMedGoogle Scholar
Ben Simon GJ, Macedo AA, Schwarcz RM, Wang DY, McCann JD, Goldberg RA. Frontalis suspension for upper eyelid ptosis: evaluation of different surgical designs and suture material. Am J Ophthalmol. 2005;140(5):877–85.CrossRefPubMedGoogle Scholar
Pang NK, Newsom RW, Oestreicher JH, Chung HT, Harvey JT. Fasanella–Servat procedure: indications, efficacy, and complications. Can J Ophthalmol. 2008;43(1):84–8.CrossRefPubMedGoogle Scholar
Kakizaki H, Zako M, Ide A, Mito H, Nakano T, Iwaki M. Causes of undercorrection of medial palpebral fissures in blepharoptosis surgery. Ophthal Plast Reconstr Surg. 2004;20(3):198–201.CrossRefPubMedGoogle Scholar
Park DH, Kim CW, Shim JS. Strategies for simultaneous double eyelid blepharoplasty in Asian patients with congenital blepharoptosis. Aesthetic Plast Surg. 2008;32(1):66–71.CrossRefPubMedGoogle Scholar
Wolfley DE. Preventing conjunctival prolapse and tarsal eversion following large excisions of levator muscle and aponeurosis for correction of congenital ptosis. Ophthalmic Surg. 1987;18(7):491–4.PubMedGoogle Scholar
Hass AN, Penne RB, Stefanyszyn MA, Flanagan JC. Incidence of post blepharoplasty orbital hemorrhage and associated visual loss. Ophthal Plast Reconstr Surg. 2004;20(6):426–32.CrossRefPubMedGoogle Scholar
Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA, and Participants in the Centers for Disease Control and Prevention-Convened Experts. Strategies and clinical management of MRSA in the community. Summary of an Experts’ Meeting Convened by the Centers for Disease Control and Prevention. March 2006.Google Scholar