Eyelid Surgery - Possible Complication following the operation.
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My name is Chester McMillan. I am an eyelid surgeon. I am Ophthalmologist who specializes in surgery around the eyes. And I have been asked to talk today, about some of the complications that can arise from having surgery to your eyelids. I think it's important that patients do realize that there are potentially serious problems that can relate to eyelid surgery. But fortunately this is very rare and with the right kind of preparation, once he is to minimize these altogether. I tell patients that one of the complications they are going to get is bruising, and I tell them this is almost guaranteed. To a certain extent they can moderate the amount of bruising that they get by that postoperative care and that's a subject to another video. So bruising is a given. Infection is very, very unlikely in surgery around the eyelid, but it is always possible, when we seek to minimize this, by proper surgical technique. I don't personally give oral antibiotics after surgery, but I do ask patients to apply antibiotic cream. The incision site does take a while to heal and sutures, and stitches are normally removed to about 5-10 days. The incision goes through a process of healing and can look a little bit red for a while, but then goes white and then eventually fades away, and so a scar, which is the words we try not to use, is visible for while, but usually that heals up with no visible trace. The most dreaded complication from eyelid surgery is loss of vision and that would be caused by a haemorrhage behind the eye, so-called retrobulbar haemorrhage. Fortunately these are exceedingly rare, but they have been described and part of my postoperative regime involves having patients avoid heavy lifting or bending so that they keep their head above their heart and perhaps I play this a bit, but I am absolutely determined that I should never encounter this and these are some of the things that can be done to avoid it. But that is devastating complication, but it can result in other partial total loss of vision in the eye that's operated on. It's of the order about one and ten thousand, and so it is rare, but it does exist. The most easily avoided complication that unfortunately is sometimes accounted is when patients have too much eyelid skin removed. Patients often come in seeking the removal of excess eyelid skin, and if you take to much skin from the upper eyelid, then patients find that they can't close their eyes which gets them chronically uncomfortable eyes, and this is something that needs to be discussed very carefully with patients, particularly in the cosmetic setting where they are paying money for effectively skin removal, and to some extent there's an expectation that the more skin you remove, the more value you are getting for your money, but you can take this to a certain point and once you push you push it further than that, then you get the lower dimensioning return and unhappy patients. And similarly in the lower lid, if you end up taking too much skin, you get lower lid retraction and you start to see the white of the eye, below the colored part of the eye, and that's abnormal appearance, one should seem to avoid. So those are two things that obviously relate to surgical technique, but would come down to complications if they were to happen. I always advise patients that they will get a dry eye, after surgery particularly to the upper lid surgery and this last for about 6-8 weeks and I have them use eye drops to alleviate this, and it's usually a temporary phenomenon. I tend to be cautious with patients who have had laser eye surgery either Lasik or Lasek, because this often gives them preexisting dry eye, which can then be worsened, so I would be very cautious. In my skin removal in these patients, I would counsel them accordingly. Other then that, anything can happen in surgery, but those are the sort of common things that I would like to run over with patients before surgery and make sure that they fully understand that th
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