I Have Dry Eye After Lower Blepharoplasty, is Laser Resurfacing for Wrinkles Too Risky?

If your dry eyes after blepharoplasty are caused by the eyelid not hugging the eye and allowing tears to not bathe the surface of the eye's cornea, then any treatment to the skin of the eyelid, laser or chemical peel,  to improve the wrinkles could worsen this problem.  Sometimes oculoplastic or plastic surgeons will do a tightening procedure, such as a canthopexy, to lift and anchor the lower eyelid up against the eye. Then after this heals and proves to be successful, laser resurfacing can be done. It would be wise to seek consultation with an ophthalmologist or better yet, an oculoplastic surgeon, before considering the resurfacing.

It might be well worth your time to have your lower eyelids and ocular surfaces evaluated by an oculoplastic surgeon prior to undergoing any additional eyelid treatments.  Alternatively,  almost all ophthalmologist are well versed in evaluating and treating patients with dry eyes.

Once a patient's dry eyes are optimized, consideration can be given for laser resurfacing of the lower eyelids.  In patients who have significant dry eye symptoms,  I would favor a fractional treatment rather than a fully ablative one.  Fractional treatments  (CO2 or Erbium) are usually done as a series with incremental improvement over time.  With this approach, there is the opportunity to experience one treatment and wait 6 weeks to several months before going forward with additional treatments.

Best wishes,

Mark Lucarelli, MD, FACS

Madison, WI

 

 

A full examination by a highly specialized surgeon who performs these procedures all the time is first and most important step.  The CO2 laser can be performed to improve the skin under the eyes without worsening the dryness but it has to be done carefully.  The exam may reveal that the eyelid needs to be tightened or lifted to improve dryness, and this could be done in combination with some laser.