Greetings, Well, my problem are such as having congenital ptosis on my left eye. In correcting the ptosis condition i had since birth, i did went through 2 surgery in the hospital. The surgeries i had are such as follows: Year 2008: Bilateral direct upper eyelid external levator resection ( Both eyes ) Year 2009: Bilateral surgeries (Left Eye only) - pull-out a small portion of leg muscle. My eyes werent symmetrical and not able to close fully. Need advices urgently.
Doctor Answers (5)
Congenital ptosis surgery
The treatment for congenital ptosis surgery depends on the amount of muscle function of the eyelid. It seems as though your surgeon thought the muscle was powerful enough to try to tighten initially. Then it seems they added a fascia lata sling from the thigh to the left eye. Sometimes inability to close the eye can occur after surgery. Depending on the time frame after surgery,something may need to be done. For patients with congenital ptosis I tell them that it is unlikely that the eyelids will look "normal" ever even if I do surgery on them. In most cases the eye muscle is maldeveloped and surgery can improve things but not make things completely "normal".
I am not sure why you can not fully close your eyes now. Your original issue concerns a levator muscle that is non functional so surgery on that muscle is not helpful. Usually congenital ptosis correction uses the power of your frontalis muscle (forehead muscle) to help resolve the ptosis (Sling Procedure). The sling can be fashioned from fascia lata (covering of leg muscle) or Gortex suture. Finishing up on way you can't close my be related to some aggressive resection of the levator/tightening? over resection of skin?
Please send pictures
You may need correction and all depends on the your muscle movement. For the patients with congenital ptosis,the limiting factor is the levator muscle movement. please send closeup picture with eyes open and closed.
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To answer the question correctly and fully, I need to see your eye/eyelid function. It also depends how the comfort of your left eye is. However, if you are unable to close the left eye since your surgery in 2009, then something needs to be done. You likely will never have a symmetric eyes. Your goal should be able to see out of the left eye and have your eye protected (fully close).
Congenital ptosis problems
Both levator resections and brow slings are accepted approaches to the treatment of congential ptosis. In many cases, the results can be less than ideal, even for the most experienced surgeons. The most common unwanted outcomes include asymmetry, over-correction, under-correction, and inability to close the eyes. It is important to aggressively lubricate the eyes if they are not closing. In some cases, patients can adapt to this "eyelid lag", but in some cases they do not. You definitely need to be followed closely by your surgeon to ensure the surface of the eye does not become too dry. Revision surgery after congenital ptosis repair is sometimes necessary.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.