This is a follow up to my first question about eyelid surgery and dry eyes. I have moderate dry eyes, am using drops, omega 3, and restasis. I am usually affected by dry eyes when we are staying at our place in the mountains. Had this surgery 25 yrs ago but need it again. Does it affect the lacrimal gland?
Does upper eyelid surgery have a detrimental effect on the lacrimal gland in the lid?
Doctor Answers 2
Dry Eyes and Eyelid Surgery
Many patients who have eyelid surgery will experience dry-eye symptoms after the procedure. This is true for people who did not have dry eyes beforehand, and is especially true for those who did. There are a variety of theories as to why this occurs -- weakening of the eyelid muscles, inflammation, etc. In general, the lacrimal gland is not touched during the surgery. It is important, particularly in a revision case with dry eyes, to have an eye doctor make sure that you are safe for surgery.
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No but blepharoplasty will most likely have a negative impact on your dry eye status.
It is no secret that we do not operate on everyone (ethical surgeons that is). For me, as a board certified ophthalmologist and fellowship trained oculoplastic surgeon, and licensed physician and surgeon goes back to the oath I took when I completed medical school: do not harm. Eyelid surgery will have an impact on your dry eye status. This can be temporary but for a certain percentage of patients the compromised dry eye status will be permanent. Your dry eye status needs to be carefully assessed by your potential eyelid surgeon. When I am not certain, I do not hesitate to get a second opinion of a very conservative cornea specialist who I know to also be very concerned with these issues. Recognize that when I advise someone not to have or every have eyelid surgery, it is a big deal but we do this when it is clear that the potential for harm is great. If you eyelid surgeon is not prepared to make these type of decisions against their own financial interests, you are in the wrong office.