Eyelid Reconstruction & Repair
Canthoplasty
Canthoplasty is performed to horizontally tighten the lower eyelid and/or raise the lower lid if it has fallen. It is performed using a small incision on the outer corner of the eye. The goal is to bring the lower eyelid in close proximity to the eyeball and to maintain or restore the natural almond shape of the eye.
Ectropion Repair
An aging lower eyelid can become lax and rotate outward. This allows the inner side of the eyelid to be exposed to air. The eyelid becomes red and the eye becomes irritated and tears excessively. This can be repaired by tightening the lower lid using a canthoplasty. Severe Ectropion may require elevation of the soft tissue of the cheek in order to support the lower eyelid.
Entropion Repair
An aging eyelid can also rotate inward. This allows the lashes to rub against the eye, causing chronic irritation. Corrective surgery involves reinsertion of the lower lid retractors of the eyelid, using an incision on the back side of the eyelid, combined with lid tightening using a canthoplasty.
Lacrimal Surgery
Excessive tearing can be caused by an obstruction within the tear sac or tear duct. This can occur as the bony part of the tear duct within the nose shrinks with age. It can also occur due to infections in the tear sac between the inner corner of the eye and the nose. In mild cases, treatment can involve opening the tear duct with a small incision.
In moderate cases, a balloon can be used to open the tear duct. In more severe cases, a new boney opening from the tear ducts into the nose must be created, called dacryocystorhinostomy (DCR). This can be performed using a small incision on the side of the nose or endoscopically from inside the nose.
Lid Retraction Repair
Eyelid retraction, which appears as a rounding of the eye, can occur when the lower lid no longer adequately hugs the eyeball. It can be caused by an age-related stretching of the tissues of the eyelid, which is then pulled down by the weight of the cheek. It can also occur if scar tissue has developed from prior surgery on the lower eyelid or if too much skin was excised from the front of the lower eyelid.
Eyelid retraction can lead to chronic eye conditions including dry eyes, excessive tearing, redness, burning and blurred vision. The repair restores the natural almond shape to the eye. It involves a small incision at the outer corner of the eye, removal of scar tissue, and tightening of the lower lid with a canthoplasty.
Orbital Decompression
Grave’s disease, also known as thyroid eye disease, can lead to proptosis, an unflattering bulging of the eyes which can sometimes lead to loss of vision. Orbital decompression surgery expands the eye socket to create more room for the eyeball and its surrounding tissues. In mild cases, this can be done by excising some of the orbital fat around the eye. In more severe cases, a boney decompression is performed in order to remove some of the bones of the eye socket to allow the orbital contents to expand into the sinuses.
Eyelid retraction can also occur in Grave’s disease. In this situation, the upper eyelid retracts upward and the lower lid retracts downward, so that the eyelids cannot close. In this situation, surgery is performed to relax the upper eyelids and grafts may be placed in the lower eyelids so they may close properly.
Ptosis (Drooping Upper Eyelid) Repair
Weak muscles can cause upper eyelids to droop, sometimes impairing vision. Ptosis repair surgery involves tightening one of the two muscles responsible for opening the eyelid. Most of the time, this can be done on the back side of the upper lid (the side facing the eyeball) so that there is no scar. Other times, an incision is made in the lid crease of the upper eyelid in order to locate and tighten one of the muscles.
