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Young Son w/ Congenital Ptosis - Has Surgery Failed?

He had surgery to correct the ptosis in August 2010 at 17 months old. He was unable to close his eye after surgery. But as the swelling went down and with time his eye started to close more. To it only being slightly open when he was asleep. He has to have 2 hourly drops in his eye. I have noticed recently that his eye appears to be drooping more and his pupil is half covered most of the time. It is worse when he is tired. has the surgery failed? It is only his left eye that is affected.

Doctor Answers 4

Ptosis of eyelid in your child is a complex problem.

March 7th, 2011
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   The surgery has absolutely not failed but please realize that this is one of the most complex and sifficult problems in plastic surgery.  Patients with congenital ptosis often undergo many surgeries befor a pleasing reslut is attineed.  Just be confident that a pleasing result is possible and will be attine for your son.  There are many possible procedures and I recommend you see two opthalmic plastic surgeons and two ABPS-FACS surgeons for opinions. Do nt rush. Go to a major University Service.  Do you homework.  Make sure your surgeon does this weekly and make thwem prove it.  If you are not accommodated, walk out.   Your son will be fine.  Ideally at his next surgery, a team of both opthamic surgeon and plastic ABPS surgeon will be in attendance.  This is WHAT I WOULD INSIST ON FOR MY SON!   BOTH WORK TOGETHER.  YOUR HARD RESEARCH AS TO WHO IS THE BEST IN YOUR AREA WILL BE REWARDED.  Do not dispair.   It will take 3 or 4 more surgeries to hit perfection at age 19 but YOU WILL AND CAN GET THERE.   My Best.    Dr Commons.

George Commons, MD

Congenital ptosis

March 7th, 2011
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It appears there is still ptosis present.  It is possible that the surgery has failed. (If it was originally a frontalis sling procedure, sometimes the sling breaks.)  Recommend consultation with an oculoplastic surgeon.

Dr Taban

Mehryar (Ray) Taban, MD, FACS

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.8 out of 5 stars 55 reviews

Congenital Ptosis - Often Requires a Seconday Surgery

March 8th, 2015
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It is quite possible that significant improvement occurred from her first surgery despite the fact that a total correction is still not present. Close and continued followups are required with your pediatric plastic surgeon for oculoplastic surgeon. When in doubt seek a secondary consultation. Oftentimes more than one surgery is required for the best results.
Larry S. Nichter, MD, MS, FACS

It is a normal effect of ptosis surgery not to be able to close the eye completely

March 24th, 2011
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It is a normal effect of surgery not to be able to close the eye completely. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.

Web reference: http://www.chelseaeye.com/ap.htm

Joseph A. Eviatar, MD, FACS

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.8 out of 5 stars 60 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.