I'm male 27,myopic.I had a congenital ptosis surgery(left eye) on May 30,2011(fascia lata).The surgery was ok but now I find no clear improvement & it seems to be drooping.2.5 months after the surgery,it started watering during sleep and even in day time.I began feeling uncomfortable in day light.Now during sleep (specially when I change side) the eye waters a lot.I had chalazion several times in the same eye since Dec,2010 treated with steroid injection.I've used artificial tears & ointments.
Post Congenital Ptosis Surgery Complication-Why Do I Have Watering Eyes? (photo)
Doctor Answers 4
This is a very difficult surgery in adults!!
The frontalis sling procedure I think made a very nice difference in the left upper eyelid position. Not a homerun but you have to undestand that there are no homeruns with this surgery. The frontalis sling ptosis surgery is for congenital ptosis when the muscle that raises the upper eyelid is underdeveloped from birth. Unfortunately this also often prevents the eyelid form blinking properly. This can also cause a very bad dry eye with persistent corneal exposure, eye discomfort, and tearing. The surgeon must balance having the eye too open with the need for the eye to blink closed. While young children tend to adapt to this exposure, adults not so much. It is possible that the eyelid suspension may need to be weakened. It is unrealistic to expect to have a perfect result here in anyone's hands.
Congenital ptosis surgery
Your surgery results looks very good. We always overcorrect to lid position because it always drops in the first few months. Hopefully your surgeon told to expect dry eyes after surgery because that is what you are experiencing. This is more of a problem when this type of surgery is done in adulthood.
Ptosis repair with fascia lata
Sometimes after congenital ptosis repair the patient can have problems closing the eyelid. This can result in the eye being dry and thus start to tear becasue it is drying out. I would get checked out by your oculoplastic surgeon.
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Frontalis Sling Procedure
The surgery only works when you use your eyebrow to open the eye more, since your upper eyelid is now suspended from your eyebrow muscle. At baseline, with your eyebrow relaxed, as you can see in your provided photographs, the eyelid is slightly droopy but still clears your pupil (you can see the light reflex in both eyes if you look at the first photograph), which is actually the goal of the surgery. Most likely, if you were to use your eyebrows, the eyelids would match more as your left eye would open up. Your eyelid could not safely be set any higher with the eyebrow relaxed or else it would endanger the health of your eye because you would not be able to close it. I suspect that may already be an issue since you are complaining of discomfort and watering of that eye. I would suggest trying lubricating ointment and artificial tears (ointment at bed, tears during the day).