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Greetings.I will be happy to answer.Do you think you can share the picture of that area without showing your identity.What previous surgery was performed?
hi, my name is ***** ***** an ophthalmologist.
thank you for your question and photo.
this can be fixed easily and successfully with minor surgery (either in the operating room or office). that they surgery would do is cut out notch and then reapproximate the two edges of the eyelid edges with sutures. if done meticulously, it will heal with very little scar. you should consult an ophthalmologist or oculoplastic eye surgeon.
hi, you cut up about 10mm in the shape of a pentagonal wedge and stitch it together (with internal absorbing sutures and skin sutures that are removed about 1 week later).
if you really want to see the details, I can direct you to videos on youtube. they can be graphic however.
here is a link to some videos.
hi, yes you would have a mild amount of swelling that would go away after 1-2 weeks.
no, you make two vetical incisions first, then two angled incisions like a triangle to form a pentagon.
hi, for a wedge resection procedure to fix an eyelid notch, you should not need to make horizontal eyelid incision like that. that type incision is often done as well, but for other types of eyelid surgeries.
are you referring to the first photo you posted? if so, it is hard to tell since the photo is zoomed in. a wider angle photo would be better.
I see the notch in the first photo, a wider photo of the upper and lower eyelid would be helpful.
the last 3 photographs appear to be after surgery. they are a little blurry and has swelling, so hard to compared these last 3 with the first.
are you asking if the original procedure was done correctly? or are you asking what new procedures can be done to correct the notch you have now?
i would be helpful to get more photos of the original of the notch to see all the landmarks of the eyelid. it is helpful to see a current photo as well absent all the swelling.
it appears you have a lot of scarring on the inner aspect of that upper eyelid.
what was the cause of the original injury?
can you show me another photo from before the surgery?
hi, it looks like the area of chemical injury was large. in this case, a standard wedge resection that i reference in the youtube vision may not work since it is good for small areas. in your case, that may have been the reason your doctor made a larger horizontal incision to allow the eyelid edges to come back together.
future surgery options may be needed to address the scar tissue and that may require a skin graft to allow the eyelid to close better.
hi, yes, the levator is what allows the eyelid to move up and down. if the levator is shortened to much, it can cause the eyelid not to close completely. the skin overlying the levator also contributes. if you do not have enough skin redundancy, then that can cause the eyelid to not close all the way.
most of the time the levator is too stretched and needs to be cut shorter.
in your case, i would not think the levator would not need to be cut.
if it had been cut short, then it can be extended, lengthen with sutures.
no, I am an ophthalmologist in california, usa
the tarsal plate cannot be extended. one procedure which can help is disinsert the eyelid from the outside corner of the eyelid which allows the eyelid to stretch better toward the inside corner.
sorry that you have gone through this.
there are options in terms of fixing it. I'd recommend you consult with an experienced oculoplastic surgeon to discuss your options.
there are many her in usa and california.
there should be many excellent surgeons in UK as well, but I do not have any personal knowledge of particular doctors.
hi, you cannot add it it but you can release any scar tissue and reattach it higher up (essentially lengthening it).
if reattached too high, it can cause ptosis. so you has to be customized to your situation.
what would you like to know about stem cell deficiency?
when you have time, please rate my answers so I can get credit for assisting you.
can you clarify a little more about what type of surgery has occurred with the eye?
the cornea is the part on the surface of the eye. stem cells continually repopulates the surface cells of the cornea and are found in the periphery. these stem cells can be damaged from trauma, chronic contact lenses, or chemical injury. if you have stem cell deficiency, the cornea has a hard time to rejuvenate itself and prone to injury and abrasions.
amt or amniotic membrane (brand name omigen) is placed on the surface of the and provides a scaffold for the remaining stem cells to heal the eye. if the other eye is healthy, you can take a graft of the stem cells from that eye and put it on the sick eye.
hi, very difficult to to answer. it depends on what tissues you are using together. if it is orbicularis muscle to orbicularis muscle, then vicryl is ok.
hi, cornea perforation can be repaired with glue. however, this is only a temporary fix. you can use ptencam to image the side of the corneal defect and see if it is getting smaller and healing.
pentacam image is taken from frontal view. it can still image the glue from side view but the image will have oblique sections of the glue.
no, but some doctors have experimented with high resolution ultrasound for eyelid.
since there would be alot of scarring, it will be very difficult to know what layers were sutured together.
correct, the original surgeon knows best.
you are welcome.
hi, you would not need much pain medicine, maybe for 2 or 3 days only.
hi, i am not familiar with ganzfield electroretinograms. I do see the pupil damage on the photo (almost 360).