Oculoplastic Surgery
Oculoplastic surgery is performed by oculoplastic
surgeons who are trained in plastic and reconstructive
surgery as it relates to the eye and surrounding
structures. The surgeons have also completed full
training as eye surgeons (ophthalmologists).
Aging and the Eyelids
Many people develop droopy eyelids, or "ptosis",
as they age. As the eyelid droops, vision may
be impaired due to the eyelid covering the front
of the eye. In addition to droopy lids, many people
also develop excess skin and fat in their upper
eyelids as they age.
Your doctor will determine whether you have
ptosis, excess skin or fat of the eyelids, or a combination
of these, and will refer you for treatment
toward your particular situation. Surgery is performed
using a local anesthetic. The incision is
usually placed in a naturally occurring crease in
the upper eyelid skin, which will serve to hide the
incision. Surgery typically takes 1-2 hours and
you are able to go home the same day. Usually,
you will be seen one week after surgery to remove
your stitches. Some bruising around the eyelids
occurs in all patients and typically resolves over a
1-2 week period.
Tear Drainage Problems
There are many reasons for people to have
watery eyes. In some cases, surgery may be able
to reduce the amount of watering. The tears normally
drain from the surface of the eye through
the eyelids and into the nose. If the drainage system
is blocked, the tears cannot leave the surface
of the eye and may spill onto the cheek. Your surgeon
will determine whether the drainage system
is working properly or if a blockage is present.
If a blockage is present where the drain starts in
the eyelid ("punctum"), your surgeon may suggest
a procedure to widen the drain opening ("punctoplasty").
This usually takes 20-30 minutes and
is performed with local anesthesia. If the blockage
occurs further in the drainage system pathway
("nasolacrimal duct"), you may require surgery
to bypass the blockage and create a new
pathway for tears to drain into the nose. The
surgery, called DCR ("dacryocsytorhinostomy")
takes approximately 1 hour and is typically performed
while you are under general anesthesia.
The procedure has a very high success rate (>90%),
but some patients may require additional surgery
to improve their tearing.
Eyelid Malposition
The eyelids are designed to protect the eyes. As
we age, the lids may stretch and pull away from
the surface of the eye, and may also turn in
("entropion") or turn out ("ectropion"). This
may cause the surface of the eye to become irritated
and may cause the eye to water. Surgery can
often restore the normal position of the eyelid.
The procedure is performed under local anesthesia
and typically takes under an hour. Most patients
notice improvement of their symptoms in the first
few weeks after surgery.
Skin Cancers of the Eyelid
We are all at risk for developing skin cancer. Fair
skin and increased exposure to sunlight increases
this risk. The eyelids and face are common locations
for skin cancers to develop. The most common
types of skin cancers are basal cell carcinoma,
squamous cell carcinoma, and melanoma.
You should inform your doctor about any
growths on the eyelid or face that you are concerned
about, whether they be new or old, especially
if they have increased in size. Each lesion
will be evaluated and your doctor will discuss
with you if they should be biopsied and/or
removed. In most cases, the diagnosis cannot be
made until a biopsy is performed. The biopsy
usually takes 15 minutes and is performed using
local anesthesia. If the biopsy shows skin cancer,
additional surgery may be necessary. The
amount of additional surgery depends on the
type and extent of skin cancer present, with the
goals of removing the entire tumor and to
reconstruct the eyelids to protect the eye. With
these goals in mind, surgery will be planned to
offer the best cosmetic outcome possible.
The Orbit ("Eye Socket")
The eye socket contains the muscles that move
the eye and the bones and fat that protect it.
Occasionally, the socket may be affected by
injury, inflammation, tumors, or by certain
medical disorders. If you are referred for evaluation
of an orbital problem, your doctor will
likely order a CT scan or MRI to assist in determining
the location and cause of the problem.
Anophthalmia (Loss of an Eye)
The loss of an eye, understandably, is very difficult
for the patient. The oculoplastic surgeon is
one member of a team to assist with this transition
and assist in ensuring the best possible outcome.
After the eye has been removed, an implant
is placed in the eye socket and the muscles that
moved the eye are usually attached to the implant.
After the socket has healed, the patient is seen
by an "ocularist" who fits them with a prosthesis.
This is referred to as a "glass eye", although they
are not glass and have excellent cosmetic appearances.
Patients typically continue to see the oculoplastic
surgeon periodically after surgery in order
to ensure the health of the socket. Your doctor
will make sure that you have a comprehensive
eye care professional involved in your care to
assist in maintaining the health of the remaining
eye. Protective eyewear will be encouraged at all
times to prevent injury to the remaining eye.
|
Home • Legal Information & Disclaimer
© 2010 Boston Eye & Laser Surgery Center All Rights Reserved • Website by IX Interactive
|
Oculoplastic Surgery