Im 27 and I had a congentinal ptosis since I was born. 2 weeks ago, I had my 1st ptosis surgery for my right eye using frontalis sling silicon rod method. I know it's too early, but my downgaze is looking very weird and not asymmetrical with my left eye. Would this be as permanent result? I already informed my doctor about my concern and he asked me to wait for another 3 months. Should I undergo for another surgery? Is this over corrected?
Doctor Answers (5)
At two weeks, you are still very early in the procedure outcome process so do as the doctor says…wait, be patient, and then evaluate the outcome.
Congenital ptosis is caused by an abnormal eyelid muscle.
Congenital ptosis surgery is quite challenging. The levator muscle that is responsible for elevating the eyelid is malformed, and not only does it not work well to elevate the eyelid, it also does not stretch well in downgaze.
So I would suspect, that even before surgery, your right eyelid was not moving well in downgaze. The surgery may have exacerbated this situation, and it is a compromise that you would have to accept if you want your eyelid to look more symmetrical in the open, straight aheady position.
Your cornea will need to be evaluated by an oculoplastics surgeon to assess dryness and your comfort also will help judge whether this is a tolerable situation for you.
Sling for ptosis
2 weeks is too early to evaluate the results from any surgery let alone ptosis surgery with a sling. if you do not have an exposure issue, then hang in there, the frontal view looks pretty good. good luck
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These surgeries are far from perfect.
This might be an acceptable result in a very abnormal eyelid.
The most important issue here is eye comfort. Is the operated eye comfortable? If it is, then you are tolerating the sling surgery. If your eye is not comfortable, then you are not tolerating the surgery. This type of surgery is often not well tolerated and it may need to be adjusted or taken down altogether if the eye can not tolerate being open as the surgery itself interferes with blink function. Young children adapt remarkably well to the surgery, but adults, not so much.
If your surgeon was an ophthalmologist or oculoplastic surgeon, they are likely looking closely at the issue of how your eye is tolerating the new openness of the eyelids. However, if your surgeon has some other type of training, I strongly recommend that you get immediately seen by an ophthalmologist or oculoplastic surgeon.
Asymmetric eyelid appearance in downgaze is one of the side-effects of the frontalis sling procedure. As long as you are able to close your eyes, it is something you may have to accept. Surgery can be done to improve the asymmetry in downgaze but then it would be more asymmetric looking straight ahead.