Upper eyelid ptosi (blepharoptosis) is a common disease of the upper eyelid. It can occur uni_ or bilaterally. With the exception of congenital blepharoptosis, the most usual causes include laxation due to increased age, diseases affecting the muscles and nerves of the eyelid, e.g. myasthenia gravis and certain autoimmune disorders (connective tissue disorders).
Blepharoptosis can be classified according to the functionality of a muscle (levator palpebrae), responsible for eyelid elevation and is measured in mm: excellent 13-15mm, good 8-12mm, fair 5-7mm, poor less than 4mm.
The operation
In cases of severe blepharoptosis, the “frontalis sling” technique is used. In this method, fascial (or artificial) grafts are taken from another area (mainly temporal muscle or tensor fascia lata in the leg) and the are used as slings through which the thickest part of the eyelid (the tarsus) is anchored on the forehead muscle. In moderate blepharoptosis, a part of the relaxed levator muscle is removed so that its length is shortened (Fasanella-Servat procedure).
Complications
Over_ or undercorrection. Infection is rare in the eyelids.
After the operation
Swelling and bruising are usually prominent after any operation of the eyelids. Therefore, ice packing of the forehead is advised for the first 24 hours or cold compresses over the eyelid. It’s not advised to socialize for about 5-7 days. Sutures are removed after 5 days. Pain is moderate and can be easily controlled with tablets.