1 in 30,000 Become Blind After Eyelid Surgery - Fact or Fiction?

1 in 30,000 may be an accurate number.  It may even be higher if you count for all the weird mishaps that can happen, i.e. CO2 laser scatter, eye infections, injury with instruments, serious corneal abrasions, etc.

The older style eye surgery where fat was aggressively removed from the eye was more likely a cause.

Obviously do not cut corners on your eye surgery.

To my knowledge,  the best estimate in loss of sight  (from hemorrhage--ie excessive bleeding into the orbit) from blepharoplasty is approximately 1/22,000 per eye.  Of course this is an average,  and other factors like use of blodd thinners, or aspirin,  skill and experience of the surgeon,  patient's care in following the post-surgical instructions would certainly have a bearing on the risk.

 

Hope this helps.

 

Mark Lucarelli, MD, FACS

Madison, WI

When I speak to patients I aways go over each and every possible complication. That being said I compare these type of freak accidents to being struck by lightening. It CAN happen but it almost certainly NEVR will. The fact of the matter is that driving on the freeway is much more dangerous than surgery

Having said that the risk is real.  Every time eyelid surgery is performed there is a risk of visual loss.  For this reason, it is important that your assessment prior to eyelid surgery include an examination of your eyes including an assessment of your vision.  Experience has some bearing on the rate of visual loss and certain procedures may have a higher risk of bleeding behind the eye which is the most common cause of blindness after eyelid surgery.  Certainly your eyelid surgeon needs to be able to identify and know how to manage bleeding behind the eye, also known as retrobulbar hemorrhage.

When a surgeon states that they have never experienced a retrobulbar hemorrhage in a patient, they have not been in practice long enough.   A retrobulbar hemorrhage, which may occur perhaps one case in a 1000,  does not necessarily lead to blindness.  Immediate recognition of the problem with evidence of pushing forward of the eye, pain, reduced vision, and impairment of the pupillary function, and assessment of elevated intraocular pressure and rapid intervention by the surgery can preserve vision.

What is the actual risk of visual loss?  It is only estimated.  Approximately 250,000 cosmetic eyelid surgery were performed last year in the United States.  If the rate was one in 30,000 cases, this would mean that about 8 patients lost vision in one of their eyes as a result of eyelid surgery.  This could be about right.

Bottom line is that yes, it is possible to loose vision as a result of an eyelid surgery.  You can reduce your risks by disclosing to your surgeon all medications and herbal products and to follow all directions regarding preparing yourself for surgery.  Your surgeon should personal examine your eyes and check your vision prior to eyelid surgery.  The risk of visual loss is small but not zero.  If you are concerned about this risk, discuss the issue with your eyelid surgeon and seek surgeons who is qualified to handle any eye emergencies that might arise in association with your eyelid surgery.

Dear kee2,

This is more like a freak accident.  For more accurate statistics, talk to the plastic surgeon that is going to do your procedure.  This should go along with all statistics because some surgeons are better than others.

The main symptom of bleeding that is dangerous is unrelenting pain.  If you catch it, there are usually minimal sequelae.  If you go to an experienced surgeon, this shouldn't happen.

Best,

Nima Shemirani

The possibility of blindness after eyelid surgery (Blepharoplasty) is 0.04% according to the plastic surgery literature. This complication is due to bleeding with in the orbit that is restricted by the orbital septum and orbit structures. The bleeding source is usually from fat compartment blood vessels that have not been properly controlled after fat removal. The accumulating blood creates increase pressure and reduces the blood flow and oxygen to the optic nerve leading to blindness.

It is imperative for the patient to inform the surgeon of any change in color perception, change in visual acuity or any sever swelling and pain. This is a true surgical emergency that needs to be treated as soon as possible to avoid permanent damage.

This complication is extremely rare and with careful attention and proper technique eyelid surgery is a very safe and gratifying procedure.

The rate of blindness after blepharoplasty is probably unknown as thousands of procedures are performed in office settings and the number of procedures is only estimated. The cause of blindness is bleeding, and estimated rates of blindness have been 0.04%, a very low number. The majority of plastic surgeons will never experience such a devastating complication. The risk is real as we all must understand, though a very rare one.
Best of luck,
peterejohnsonmd

It happens very rarely and the true statistic is probably around one in a million. But if it happens to you , it is 1 in 1.

This is rare complication but known complication. The main cause of this is bleeding after surgery and delay in diagnosis.

Kee2,

While there can be complications from any type of surgery; I have never heard of this statistic.  Blindness due to an eyelid surgery has never happened at my practice.