Upper Blepharoplasty: 3 Questions About Eye Protectors/Shields During the Operation

The use of protective on shields during upper Blepharoplasty surgery is determined by the surgeon.  In general, topical anesthetic drops are applied so that it is not uncomfortable.  Personally I do not use during upper Blepharoplasty procedures and have not found any increase risk in my practice over the past few decades

Corneal shields can be helpful, but can also introduce unnecessary risk into an upper eyelid procedure.  I do not use them for this purpose and do not feel there is a breach in safety by avoiding their use.

Using eye shields during blepharoplasty surgery is not essential to the safety of the procedure.  For upper blepharoplasty surgery only the outermost skin and occasionally muscle is removed.  The inner conjunctival lining and the deeper muscles of the eye are not treated and therefore should provide a protective layer for the eye.  Corneal shields are essential though if a laser procedures will be performed concomitantly with the blepharoplasty.  The laser can cause significant damage to the eye if not handled carefully.  Specifically visual impairment or blindness can occur if proper eye protection is not used creating damage to the retina or cornea.  Anesthetic eye drops will numb the eye so you don not feel the shields in place.

 

For upper blepharoplasty alone, your eyes are closed during the entire operation, and there are no incisions made on the inner aspect of the eyelids. Therefore, your eyes are protected and I do not use eye shields during the operation. 

Upper eyelid surgery is very well tolerated with local anesthesia alone.

Some surgeons, prefer to place a shield during the time of surgery, and although they appear to be uncomfortable, they will place some anesthetic drops in the eyes prior to placing the shields to avoid any discomfort.

 

Dr. Jamil Asaria

FACE Toronto

Upper Blepharoplasty surgery can definitely be done without eye shields.  Each doctor may have a preference on whether to use them or not.  If they are used, normally numbing drops are placed into the eyes first, so that the shields are not uncomfortable.  I would discuss your concerns with your surgeon to see what your options are in regards to the surgery.    

When I am doing upper eyelid surgery I do not routinely use eyelid shields and have had no problems in 33 years.I think this is a surgeon's choice/preference.I fill simple is always the best.

I use them often in many kinds of eyelid operations, often under only local anesthesia. The anesthetic eyedrops numb the surface of the eye. Some procedures such as cutting with a radiofrequency unit or electrocautery can have some risk for the eye. But some doctors work without them. You should not expect any significant discomfort from the shields.

If you do your research on the internet or on forums you will read comments from surgeons who advocate eye shields for every procedure or state that they are not necessary. I don't use eye shields for upper or lower blepharoplasty as the eyelid itself can be used to protect the eye during the procedure. In reconstructive cases where a portion, or all, of the eyelid is being reconstructed I will use an eye shield as there is inadequate tissue to protect the eye during the procedure.
To answer your specific question, placement of eye shields for procedures under local anesthesia is not unpleasant if done properly. The anesthetic drops mentioned by Dr. Asaria are also very helpful.Stephen Weber MD, FACS