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What is Blepharoplasty?

Blepharoplasty is a surgical procedure used to address trauma to tissue around your horse’s eye, when tissue has been damaged or removed from the eyelid and requires reconstruction. When removal of growths on your horse’s eyelid, trauma from injury, excess skin, or scarring interfering with your horse's vision occur, blepharoplasty to repair gaps in tissue around the eye or repair excess or damaged tissue can be performed by your veterinarian. The procedure may be performed on the upper or lower eyelid, and is usually performed when ⅓ or more of tissue around the eye globe requires addressing. Your horse will require general anaesthetic for this procedure and a veterinarian with training in reconstructive surgical techniques.

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Blepharoplasty Procedure in Horses

Prior to blepharoplasty, your horse will be administered antibiotics and anti-inflammatories, if deemed necessary. Your horse will be sedated and given an intravenous anesthetic and lowered gently to the ground. General anesthetic may then be administered by endotracheal tube and maintained by gas.

The area around the surgical site is cleaned antiseptically, with caution being used not to irritate optic tissues, and as much hair removed as is possible. Your veterinarian will then use one of several reconstructive surgical techniques to repair the gap, wound, or excess tissue present at your horse’s eyelid. Reconstructive surgical techniques may include:

  • H-plasty: use of a sliding skin flap created by surgical incisions on the tissue adjacent to the missing eyelid tissue to cover the gap and affix with sutures.
  • Transconjunctival advancement graft: skin is used from the opposite eyelid to fill gap where eyelid tissue is missing on the affected eye.
  • Full thickness eyelid graft: a graft from the upper eyelid is harvested and used on the lower eyelid.
  • Z graft - triangular skin grafts from surrounding tissue are harvested and affixed to the eyelid gap with sutures.

Once reconstruction is complete, bleeding is addressed, sutures are put in place and dressings are applied as required. Your horse will then be monitored as they recover from anesthetic so as not to injure themselves. They will be provided with assistance in getting up if necessary and kept in a safe, secure environment until they recovery balance and functioning.

Efficacy of Blepharoplasty in Horses

Blepharoplasty to provide functional and cosmetic repair to eyelid tissue is usually successful and associated with a satisfactory outcome. Siding skin flaps are the most commonly used reconstructive technique used, however eyelid skin may not stretch sufficiently to provide adequate donor skin and other techniques may be required.

Blepharoplasty Recovery in Horses

After blepharoplasty, the eye will need to be protected to ensure your horse does not injure it by rubbing the surgical wound. A hood with a hard eyecup may be employed to protect the surgical site. Non-steroidal anti-inflammatories and antibiotics will usually be prescribed postoperatively. The eye wound will need to be regularly lavaged to remove contamination and promote healing. Ice packs can cause damage to new skin grafts and should be avoided. Dressings, if present, will require regular changing. The wound should be monitored to ensure infection or rupture has not occurred and to observe healing. The eye will need to be protected from risk of mechanical harm for a few weeks post-surgery.

Cost of Blepharoplasty in Horses

Because a veterinarian with training in reconstructive techniques and general anesthetic is required for this procedure, the cost can vary from $1,000 to $2,000 depending on your location, mileage, and availability of a clinic equipped to perform this procedure.

Horse Blepharoplasty Considerations

Delicate eyelid tissue and associated structures are subject to complications, such as infection, and may be difficult to work with. Tissue for grafting may be limited and inelasticity may limit the ability to cover deficiencies in damaged tissues. General anesthetic presents a risk in horses both during surgery and in recovery. Monitoring vital signs while your horse is under anesthetic and assisting them in recovery by providing safety, security, and support will reduce the likelihood of complications from anesthetic administration.

Blepharoplasty Prevention in Horses

Injury to the eye is a major cause of blepharoplasty in horses. Ensuring that the stabling area does not have nails sticking out or sharp objects your horse could injure themselves on will reduce the likelihood of them becoming injured during housing. A safe turn out area with appropriate fencing and free from debris such as sticks or other items that your horse could puncture their eye area with during grazing will also reduce the likelihood of eye trauma requiring surgical repair.