What is Ptosis Repair

Ptosis repair is a procedure to tighten a drooping upper eyelid (ptosis). Ptosis usually happens when the eyelid muscles become weak and loose from aging. It may also be caused by an injury or nerve damage. Children can be born with ptosis (congenital ptosis).

You may need this surgery if ptosis is causing vision problems. You may need ptosis repair in one or both eyes.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to muscles, nerves, or blood vessels near the eye.
• Dry eye.
• Under-correction or over-correction of your vision that requires a second surgery.
• Difference in the ways your eyes look (asymmetry).

What happens before the procedure?

• You will have a detailed eye exam to help your surgeon plan the procedure. Your surgeon will take measurements of your eyelid opening and test your eyelid muscles.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your surgeon will make a cut (incision) in a natural crease of skin near your eyelid. In some cases, the incision can be made just on the underside of your eyelid.
• Your surgeon will locate the muscle that lifts your eyelid through this incision. This muscle may be tightened with stitches (sutures). In some cases, a section of the muscle may be removed.
• If the eyelid muscle cannot lift the eyelid, it may be attached with sutures to the muscle that raises your eyebrows.
• If there is excess skin in your upper eyelid, this skin may be removed (blepharoplasty).
• The incision will be closed with sutures.
• An antibiotic and moistening eye drop will be placed in your eye.
• If both eyes are being repaired, your surgeon may then do the procedure on your other eye.

The procedure may vary among health care providers and hospitals. The procedure will also vary depending on the condition of your eye.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.

Ptosis Repair, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Swelling.
• Bruising.
• Difficulty closing your eye, especially at night.
• Dry eye.

Follow these instructions at home:

Incision care

• Take care of the area where the surgical cut (incision) was made as told by your health care provider.
• You may have removable or absorbable stitches (sutures) in your eyelid incision. You may also have tiny adhesive strips placed over the incision. You may need to return to your surgeon to have these sutures and strips removed.
• Check your incision area every day for signs of infection. Watch for:
  • Redness, swelling, or pain.
  • Fluid, blood, or pus.
  • Warmth.
  • A bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider. This includes any moistening eye drops.
• If you were prescribed antibiotic eye drops, use them as told by your health care provider. Do not stop using the antibiotic even if your condition improves.

General instructions

• Use cold compresses to reduce eye pain and swelling. Do this for about 20 minutes every 2 hours for the first 2–3 days or as told by your health care provider.
• Keep your head raised (elevated) on a few pillows when resting and sleeping.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have redness, swelling, or pain in your eye.
• You have a fever.
• You have trouble closing your eye.
• Your eye is dry and irritated.
• Your incision breaks open after being closed.
• You have a change in your vision.

Get help right away if:

• You have fluid, blood, or pus coming from your eye.
• You have severe loss of vision.