I write this with an ice pack full of frozen peas covering my left eye and most of my right so that I can only see by tilting my head back to look at the screen. I am on painkillers so if this doesn’t make a lot of sense, that’s why. Yesterday I went to the University of Iowa Hospitals Eye Center and had a Levator Advancement Procedure, which is fancy talk for getting my eyelid fixed. I was born with a condition called ptosis in my left eyelid, meaning it’s always been droopy and I’ve never been able to open that eye all the way. Most people have said they never even noticed it. Personally, I only really ever noticed it in pictures.
I’ll rewind a bit to about a month ago when I went to IA City for the consultation. They did a field of vision test and then taped my eyelids up and did it again and found that with the tape I had a 35% improvement in my field of vision. They were going to schedule me for surgery sometime in November but had just had a cancellation so I was able to get a surgery date of August 24.
Waiting for the day of my surgery was both exciting and nerve-wracking. The procedure itself was not nearly as bad as I had imagined, thanks to the fact that it was done externally and I was able to keep my eyes closed almost the whole time. The really super bizarre part was, as they peeled back layers of my eyelid, more and more light was seeping through.
I’m not sure if they say this to everybody or not, but the surgeon’s assistant lady told me several times that I have amazing pain tolerance. She said when they injected the anesthetic into my eyelid that I didn’t even flinch. She also said that I didn’t flinch at all when they were putting in the sutures. So, either she says that to everyone to make them feel good or I am just the coolest ever. I’ll just pretend it’s the latter.
Last night my sweet bf came over to see how I was doing. He’s a rock star. 🙂
Ok, now I’m posting a really gnarly pic of my swollen eyelid. View at your own risk! hehe
And, last but not least, here is my surgeon’s summary of the procedure… enjoy! 🙂
Pre-operative Diagnosis: Congenital ptosis, left upper eyelid
Post-operative Diagnosis: Same
Procedure: levator advancement, left upper eyelid
Description of Operation/Procedure:
After the risks, benefits, and alternatives were discussed with
the patient and informed consent was obtained the patient was
brought to the operating room where intravenous sedation with
Versed was administered. Topical proparacaine 0.5% was instilled
in each eye. The eyelid skin was cleaned with isopropyl alcohol.
The eyelid creases were marked with gentian violet. Local
anesthetic was injected subcutaneously in both upper lids.
Approximately 1-1.5cc of anesthetic was injected in each eyelid.
A “time out” was performed to ensure the correct surgical site
was being operated on. The patient was prepped and draped in the
usual sterile fashion.
Using a Colorado needle an incision was made along the left
eyelid crease. Using Paufique forceps, traction was applied on
either side of the incision, the dissection was done to expose
the underlying orbital septum. Hemostasis was achieved with
bipolar cautery. The orbital septum was incised and the
pre-aponeurotic fat was exposed. A Jaffe eyelid speculum was
placed and secured to the surgical drape superiorly. The levator
aponeurosis was exposed.Using Westcott scissors the levator
aponeurosis was released off the tarsal plate for approximately
7-8mm. This dissection was done at the medial edge of the pupil
where the eyelid peak should form. This bared the tarsal plate.
The aponeurosis was then dissection from the underlying Muller
muscle using Westcott scissors and blunt dissection. A double
armed 5-0 nylon suture was passed horizontally through the tarsal
plate in a lamellar fashion. Each arm of the double armed suture
was passed through the under surface of the levator aponeurosis.
This suture was temporarily tied in a slip knot. The patient was
brought to the sitting position. The eyelid height and contour
were examined. The patient was brought to the supine position and
adjustments were made in the suture. The suture was tied
permanently. Three interrupted sutures were placed incorporating
the levator aponeurosis to allow for formation of a lid crease.
The skin was closed with a running 6-0 Prolene suture. The
eyelids were washed with wet 4×4 gauze. Erythromycin ophthalmic
ointment was placed on the eyelid and ice packs were placed.