Can I wear my RGP contact lenses after ptosis correction and Asian upper eyelid blepharoplasty?

Thank you for your question. You didn’t submit a photo but ask if it alright to wear rigid gas permeable lenses after undergoing ptosis surgery. You state you’ve been wearing these lenses for 30 years, but you developed ptosis, so you’re concerned about recurrence after wearing the lenses.
I can share with you how I counsel patients in my practice with similar situations. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Eyelid ptosis is a very common issue we deal with in our practice, as well as Asian eyelid surgery, and the combination of eyelid surgery with eyelid ptosis. I can basically breakdown the variables that may have contributed to your ptosis.
There is a well-known association of wearing hard contact lenses causing of ptosis. The theory is when the eyelid blinks, the levator muscle rubs against the contact lens, so the muscle tendon called the levator aponeurosis can become thinner, resulting in some degree of ptosis. There is also an association with other variables of different types of contact lenses.
You’ve been wearing these lenses for 30 years, and you’re middle aged. There are other causes of ptosis that are not uncommon at this stage of your life, which is called involutional ptosis. This situation is where the muscle that lifts the eyelid, again the levator aponeurosis, can become thin or stretched, but it’s more of an age-related issue.
So what do you do to try to maximize the longevity of your surgery? That’s a challenging question because you are dealing with an important part of your visual function when wearing these contact lenses. Often, people who wear rigid gas permeable lenses like yourself have a significant astigmatism, or conditions such as keratoconus, so their cornea needs a proper lens to see very well. Often, if people don’t need contact lenses or can wear glasses, they choose to wear glasses. I suspect if you have a type of condition where the contact lens is necessary, then you have to accept a certain amount of wear and tear of your eyelid tissue moving forward may still transpire. Again, it’s a matter of balance.
I think this is a coordinated effort between your oculoplastic surgeon who performed your surgery, and your ophthalmologist who might be able to offer you maybe softer lenses, or other options in ophthalmology such as being possible candidate possibly for laser vision correction, or other alternatives. The point is there is a risk of the foreign body or contact lens wearing down the eyelid tissue, so you may deal with the ptosis again.
It is also important to remember to use lubricating drops that can hopefully help with some of the friction between the eyelid and the contact lens, and good ocular hygiene, proper contact lens hygiene, and other things that can minimize the potential inflammation and irritation  associated with contact lenses. As we get older, also understand the eyes can get a little more dry, so that’s another variable to be factored in. As I said earlier, involutional ptosis or  age-related thinning of the tissue can happen regardless of the contact lens. It’s not necessarily a direct cause and effect, but it can be multiple variables contributing to the ptosis. I hope that was helpful, I wish you the best of luck and thank you for your question.

You should emphatically NOT wear your rigid gas permeable contact lenses immediately after your ptosis correction.  The risk you face when you replace your contact lenses immediately after surgery is that  you my exert traction on the suture repair that your surgeon has performed in shortening the levator oculi muscle to correct your ptosis.  Before manipulating the upper eyelid, which you must do in order to place your contact lenses, you must allow enough time to pass for this repair to grow strong enough that it will be able withstand such forces.  In our clinic. we routinely ask our patients to abstain from wearing contact lenses after their ptosis correction for two months.

Good question. Please follow up with your surgeon. We usually recommend avoiding contact lenses for 2-3 weeks post surgery to prevent complication.  Hope your healing is going well.