The Dry Eye Zone

Rebecca's Blog

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Abstract: Avoiding problems in cosmetic eyelid surgery

Eyelid surgeries are a significant cause of dry eye. If you ever consider it, you should have a good corneal specialist involved and make sure the oculaplast really "gets" the issues that can affect the ocular surface.

I really appreciate that in this abstract the author specifically refers to previous LASIK as well as other dry eye risk factors. For too many, eyelid surgery was the the last straw.

Complications in periocular rejuvenation.
Facial Plast Surg Clin North Am. 2010 Aug;18(3):435-56.
Mack WP.
Division of Oculoplastics Surgery, University of South Florida, Tampa, FL, USA. drmack@tampabay.rr.com

Thorough preoperative evaluation with meticulous surgical planning to achieve facial aesthetic balance between the forehead, eyelids, and midface is imperative to avoid or decrease potential functional and/or cosmetic complications in cosmetic periocular surgery. Before performing surgery, the physician should be aware of the patient's history of dry eyes, previous facial trauma, previous injection of Botox Cosmetic, history of previous laser-assisted in situ keratomileusis, and past facial surgery. A full evaluation should be performed on the upper eyelid/brow region to assess for the presence of brow ptosis, brow/eyelid asymmetry, dermatochalasis/pseudodermatochalasis, eyelid ptosis, and deep superior sulcus. On the lower eyelid/cheek examination, special attention should be directed to the diagnosis of underlying negative vector, dry eyes, prominent eyes, lower lid retraction, ectropion, lateral canthal dystopia, lower eyelid laxity, scleral show, and lagophthalmos, with a rejuvenation goal that focuses on obtaining a youthful fullness through repositioning and reinforcing efforts to avoid the negative effects of hollowness. Intraoperative and postoperative medical and surgical management of cosmetic periocular surgery complications focus on decreasing the risk of postoperative ptosis, lagophthalmos, lid retraction, and lid asymmetry, with special attention to limiting the risk of visual loss secondary to orbital hemorrhage.
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