Hard Palate Grafts and Watery Eyes, What's Wrong?

Post a failed MFL I have bilateral lower HPG. The one in my R eye is in a different spot to the left due to initial failure to elevate lid. My left eye is vertically wider and 2mm longer. The lower lid also is a different shape (slanting upwards) My occuloplastic surgeon states no dry eye. When I lean forward the R lower lid is not tight to the lower lid I have continual watering and an ongoing sensation that my eyes are exposed despite them appearing ok.What could be wrong?

Doctor Answers 1

Photos would be very help here.

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Dear Ernurse

I remember your original emails.  I am sorry you have not been able to achieve everything you were hoping for.

These are very complex situations.  Achieving a successful surgical outcome can be very challenging.  The goal must be to achieve as symmetric result as possible.  

Anatomically, it is very important that the eyelids hug the contour of the globe.  This is not happening for the right eye.  WIth all due respect to your oculoplastic surgeon, an eyelid that does not glide on the eye surface will contribute to drying.  The eyelid can't move tears on the eye surface.  This will necessarily contribute to dry eye.  Also if the lower eyelid is not properly opposed to the eye surface, the opening for the tear drainage system will not be able to pick up tears.

I am sure you have gone to great trouble and expense to have reconstructive surgery on your eyelids.  As discouraging as this might be, this situations can often be surgically rehabilitated.  I would recommend waiting 6 to 12 months before taking this on.  

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