From the Guidelines
Recovery from chemosis after blepharoplasty typically takes 1-3 weeks with proper management. This condition, characterized by excessive swelling of the conjunctiva, is a common postoperative concern following eye surgeries, including strabismus surgery, as noted in the adult strabismus preferred practice pattern 1. The management of chemosis involves a combination of supportive therapies to reduce discomfort and inflammation, such as lubricating eye drops applied 4-6 times daily, cold compresses for 15-20 minutes several times daily during the first 48-72 hours, and keeping the head elevated while sleeping.
Key aspects of management include:
- Using artificial tears to keep the eyes moist
- Applying cold compresses to reduce swelling
- Elevating the head while sleeping to decrease fluid accumulation
- Avoiding eye rubbing to prevent further irritation
- Possibly using preservative-free ointments at night to prevent corneal dryness
In more severe cases, mild steroid eye drops such as prednisolone acetate 0.12% or loteprednol 0.5% may be prescribed for 5-7 days to reduce inflammation, as determined by the ophthalmologist based on the severity of chemosis. It's essential for patients to follow up with their surgeon or an ophthalmologist if chemosis persists beyond 2-3 weeks, as this could indicate a need for further evaluation or treatment. Protecting the eyes from wind, dust, and excessive screen time, along with staying well-hydrated, supports overall healing and recovery from chemosis after blepharoplasty.
From the Research
Recovery for Chemosis after Blepharoplasty
The recovery for chemosis, or excessive swelling of the conjunctiva, after blepharoplasty (eyelid surgery) can vary depending on the severity and underlying cause of the condition.
- Chemosis is a common complication of both upper and lower blepharoplasty surgery, though it is more common after lower blepharoplasty 2.
- The cause of chemosis is multifactorial and includes exposure, periorbital edema, and postoperative lymphatic dysfunction 3.
- The incidence of chemosis after lower lid blepharoplasty has been reported to be around 11.5 percent, with a median duration of 4 weeks and a range from 1 to 12 weeks 3.
- Chemosis can be classified into different types, including acute mild chemosis, acute severe chemosis, subchronic chemosis, and chemosis associated with lower lid malposition 3.
- Treatment for chemosis can include liberal lubrication, ophthalmic steroid preparations, ocular decongestants, eye-patching, and minor surgical procedures such as drainage conjunctivotomy and temporary tarsorrhaphy 3.
- Prevention of chemosis is important and can be achieved by minimizing triggering factors intraoperatively and immediately postoperatively, such as minimizing surgical exposure and manipulation, and maintaining a moist ocular surface 2.
- The use of different surgical techniques, such as transconjunctival blepharoplasty with canthopexy, can reduce the incidence of persistent chemosis compared to transcutaneous blepharoplasty with lateral canthoplasty 4.
- In some cases, chemosis can resolve on its own without treatment, although this can take several months 5.
- Diagnostic and therapeutic algorithms can be used to assess and manage chemosis, taking into account the underlying cause and severity of the condition 6.