How is ptosis surgery performed? What should be paid attention to during ptosis surgery?

In our daily life, we often see people with symptoms of ptosis. Ptosis means that the upper eyelid covers part of the pupil. Severe ptosis will affect vision and the eyes will not open wide.

There are two basic methods of ptosis correction surgery, one is the levator palpebrae superioris muscle shortening surgery, and the other is the frontalis muscle lifting surgery. Different surgeries are suitable for patients with different degrees of ptosis. Which corrective surgery to use requires a doctor who specializes in eye plastic surgery to make the right choice based on the patient's eye morphology.

1. Choose hospitals and doctors carefully

Before undergoing ptosis surgery, you must carefully choose a hospital and doctor. This is because ptosis surgery is difficult and requires a professional plastic surgeon who specializes in eye plastic surgery and has rich experience to perform the surgery in order to reduce the risk of complications after ptosis correction surgery and improve the effect of ptosis surgery.

2. Strengthen postoperative care

After the treatment of ptosis, postoperative care is a very important part of the entire treatment process, which requires the active cooperation of the patient's family. The main care content is to use eye drops and eye ointments to care for the eyeballs within 2 to 3 months after the operation to prevent the eyes from drying out.

3. Surgery is the main treatment, and the best age for surgery is between 3 years old and before school entry. If both eyes are severely droopy and vision is affected, surgery can be performed before 1 year old.

Surgical method: The choice of surgical method should be determined by the strength of the levator palpebrae superioris muscle. The normal strength of the levator palpebrae superioris muscle should be above 12mm. If the strength of the levator palpebrae superioris muscle is above 8mm, shortening or plication should be considered for good results. If the strength of the levator palpebrae superioris muscle is less than 4mm, frontalis muscle suspension should be considered.

The cause of ptosis caused by genetic factors is complex and can be divided into muscle-related or neurogenic. Muscle-related is the incomplete development or defect of the levator palpebrae superioris muscle, and neurogenic includes central and peripheral nerve development disorders. When looking straight ahead, if the difference in the vertical diameter of the two palpebral fissures is greater than 2 mm or the upper eyelid covers the cornea by more than 2 mm, all of which should be considered as ptosis. According to the degree of ptosis, it can be divided into three types: mild, moderate, and severe; mild (ptosis 1-2 mm), moderate (ptosis 3 mm), and severe (ptosis more than 4 mm).

Simple ptosis is the most common type, accounting for about 77% of congenital ptosis, with no gender difference. Because the levator palpebrae superioris muscle is closely related to the superior rectus muscle during development, the superior rectus muscle can sometimes be affected together. This is why some patients clinically have limited upward movement of the eyeball in addition to ptosis.

Clinical manifestations: The upper eyelid is droopy and cannot be lifted. The severity varies. In mild cases, symptoms and signs are only shown when looking upward. In severe cases, the droopy upper eyelid partially or completely covers the pupil, especially in cases of bilateral ptosis. The patient raises the head and eyebrows when looking at objects, and the eyelid skin becomes smooth, thin and wrinkle-free. In order to maintain vision, the frontalis muscle is often in compensatory spasm, and horizontal wrinkles appear on the forehead skin. Severe ptosis of one eye may also cause form deprivation amblyopia.

Ptosis with other congenital eyelid abnormalities The ptosis symptoms of other eyelid abnormalities refer to congenital ptosis accompanied by small palpebral fissures, lateral epicanthus and too far distance between the eyes. It is an autosomal dominant inheritance and is mostly bilateral.

Clinical manifestations: The patient's palpebral fissure is not only narrow in vertical diameter, but also short in horizontal diameter, only about 20mm. The function of the levator palpebrae superioris muscle is significantly reduced, and most cases are severe ptosis. The epicanthus often forms a line with the lower eyelid, and extends upward into a crescent shape ending at the tarsal plate of the upper eyelid. Because the epicanthus causes the skin at the root of the nose to expand outward, the distance between the two eyes is too short. This disease may also be accompanied by paralysis of the superior rectus muscle or the lateral rectus muscle.