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Eyelid Surgery - Complications
  • Temporary oozing from the incisions.
  • Blurring of eyesight, due to swelling of the conjunctiva, and by the use of the lubricating ointment.
  • Inclusion cysts. Little cysts occasionally develop along the suture lines. These little cysts may be easily removed under local anesthetic in the office.

Ectropion. Removal of too much skin from the lower lid can cause the lower lid to retract, exposing too much of the white of the eye under the iris. Experienced surgeons are conservative in skin removal to avoid this problem. Ectropion can also be caused by settling of relaxed eyelid tissues, particularly in older patients with existing skin laxity. It can be caused by weakness of the orbicularis oculi muscle (the circular muscle that goes around the eye) after facelift surgery. This nerve function gradually returns and the muscle tone is restored.

  • Excess Scleral Show and Lid Shortening- (See Patient R.C.)
  • Incomplete eyelid closure (lagophthalmos): Most patients do not have full eyelid closure during the first several days after surgery because of swelling. During this time, the eye needs to be protected.
  • Corneal injury: Prevention of corneal dryness is critical to avoid injury to the corneal surface. Lubricating drops are used during the day and ointment at night. This regimen keeps the cornea lubricated until full eyelid closure is regained. The cornea cannot be allowed to dry out because this can have serious consequences, including impaired vision due to corneal scarring.
  • Blindness after eyelid surgery has been reported. This may be caused by postoperative bleeding (retrobulbar hematoma) that puts pressure on the blood vessels to the eye. This serious problem is signaled by eye pain, proptosis (the eye appears to be bulging forward) and loss of vision. Urgent recognition and treatment are needed. Fortunately, this complication is very rare.
  • Scars may sometimes be conspicuous, particularly the lateral part that extends beyond the orbit. They improve with time. Occasionally, they may be revised simply under local anesthetic.
  • Infection is unusual because the tissues have an excellent blood supply. If infection occurs, it is treated with antibiotics and incision if a small abscess develops.
  • Double vision. If the surgeon traumatizes a muscle that controls the motion of the eyeball (called the "inferior oblique"), double vision can result. Fortunately, this is usually temporary. Experienced surgeons know where this muscle is located and avoid injuring it.

Swanson Center ~ 11413 Ash ~ Leawood, Kansas  66211 ~ tel: 913.663.1030
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