There are various types of eyelid surgery, including the following:
Upper eyelid Blepharoplasty is performed through incisions or cuts made in the upper skin crease that forms when your eyes are open. The excess skin and fat are removed and the incision is stitched closed. Lower lid blepharoplasty is through an incision just below the lashes, or if only fat (no skin) is to be removed the surgery is performed through an incision on the inside or back of the eyelid. The amount of skin and fat that requires removal varies between patients. Dr Wilcsek will be able to determine this at the time of your consultation. The operation usually takes 1-2 hours depending on the extent of each case and is performed under local anaesthetic with sedation at a day surgery facility.
The treatment for ptosis is usually surgery. In determining whether surgery is advisable, the individual’s age, general health, severity of the ptosis and whether one or both eyelids are involved is considered. Measurement of the eyelid height, evaluation of the strength of the muscles that open and close the eyelids, and observation of the eye’s movement will aid in determining what surgical procedure is most appropriate.
Depending on the function of the muscles in the eyelid different surgical procedures are available. Some procedures are performed through the internal surface of the eyelid with no cutting of the skin at all, more commonly an incision hidden in the lid crease skin is made so that excess skin can be removed at the same time. The operation is under sedation and local anaesthesia.
In children general anaesthesia is required.
In some patients with severe recurrent infections or deterioration of vision from scarring of the surface of the eye due to lack of protection by the eyelid, surgical treatment is absolutely necessary. Cases of mild ectropion can be treated with regular lubricants and review of the surface of the eye to monitor for any damage.
In addition long term malposition of the lid will lead to structural changes to the lid and lashes that may lead to eye problems in the future.
Temporary treatments are available. However the effect of these procedures do not last and so surgery is required for an adequate repair.
Surgery for entropion requires the tightening of the tendon of the eyelid and more importantly re-attaching the “retractor” muscle within the eyelid. This muscle is a very small muscle that can be difficult to find. If it is not properly re-attached the chance of recurrence of the entropion is high.
The operation is a day surgical procedure under local anaesthesia with sedation.