Blethraplasty - Eyelid now does not adhere to eyeball

[slbentley]

I had lower lid blethraplasty 17 days ago and had what I think was chemosis.  The left eye was pulled forward away from the eyeball all of the way across and the right eye was pulled away  at the right corner.  At one week post-op the doctor prescribed steroid drops.  At two week post op, I was instructed to apply tape underneath and pull upward and attach near outward corner of eye and to rub in an outward motion everyday 4-5 times.  I have done this for one week.  The tape is irritating the skin and the eyes have shown little, if any, improvement.  At present, The lower lid of the left eye is loose flops open away from the eyeball.  I can push it up and it will only briefly stay next to my eyeballand anytime I lean forward, even with the tape, the lid flops forward.  What is this called?  Is there hope that it will resolve itself?  Is there a procedure to correct the problem?  I am scared out of my mind.  

[Dysie]

A related discussion, HELP was started.

[yruhere4now]

Hey SL,
regarding the ectopion, has it gotten any better?  I too have that problem and I'm on week 10 and still staying inside hiding from life...

[slbentley]

I appologize, in haste, I responded and just comprehended that you said "in rare instances" additional surgery is needed.

[slbentley]

Thank you for responding so promptly.  I have not heard of post-op ectopion and appreciate having the term for reference/research.  I don't know if anyone would venture to answer this so early on, but is it common for it to resolve on it's own or does it generally require additional surgery?

I have a follow-up appointment tomorrow and will try to relax a bit for now and continue with current instructions, which does include tape applying underneath only at this point.  

Thanks again for the information.  

[Howard Rosenberg, MD]

Chemosis is massive swelling of the conjunctiva of the lid and is typically involves swelling of the white portion of the eyeball around the iris. What you are experiencing is more likely post-op ectopion as a result of early swelling, increased weight of the lower lid, and possibly pre-existing laxity of the lower lid.  Taping of the lower lid does help control the situation.   However, if the tape is irritating, other temporary minor surgical sutures are sometimes placed to help hold the lid in place.  Ultimately, if necessary, additional surgery can be used to correct the situation, if the problem does not resolve on it own with time.

You need to discuss this with your surgeon in detail.  It is very critical never to consider re-operation too soon.  In the rare instances that additional surgery is needed, full healing and scar maturation is important in order to be successful. This can require from nine months to a year to occur.