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October 1977

A Warning Regarding the Fasanella Procedure-Reply

Author Affiliations

Tampa, Fla

Arch Ophthalmol. 1977;95(10):1885. doi:10.1001/archopht.1977.04450100187027

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In Reply.—I am sorry that Dr Markovits has abandoned the sutureless Fasanella-Servat operation because of an unfortunate occurrence with his first case. Needless to say, we all have surgical complications now and then.

Although uncertain, I believe Dr Markovits acted hastily in everting the operated eyelid as early as six days postoperatively. While some patients will show minimal edema and satisfactory eyelid elevation in one week, the majority require three to four weeks for resolution of swelling and firm scar formation before the results of the operation can be assessed. It is not unusual for the ptosis to be temporarily worsened by edema and inflammation during the first week, and consequently the surgeon should sit back patiently and give the natural healing process a chance before "rushing in" to do something.

I am not at all surprised that Dr Markovits noted a 12-mm wound "dehiscence" after everting the eyelid

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