William P. Mack, M.D. is a board certified ophthalmologist who is fellowship trained and specializes in Oculoplastics and facial cosmetic surgery; discusses with Ivanhoe the new Lid Lift Goggles being tested to help patients after eyelid surgery heal and get back to their daily routine that much faster.
Interview conducted by Ivanhoe Broadcast News in November 2019.
Tell me about these goggles and how they came to be and how you started testing them.
Dr. Mack: Well, the goggles are for use after eyelid surgery. And the main issue was patients after surgery suffered bruising and swelling, so figuring out ways to decrease these. I find in my practice, whether patients are retired or in the working world, everybody wants to get back to their activities as quickly as possible. So that’s always the first question, when can I get back to my activities, working out or whatever the case may be? So the goggles offer a way for patients to potentially decrease their bruising and swelling after surgery.
So is that a big concern, bruising and swelling when you have eyelid surgery? Because it is one of the most popular types of plastic surgery.
Dr. Mack: Absolutely, absolutely. The eyelid region, the periorbital region is very vascular. Meaning that there are a lot of blood vessels in that area, so you can have significant bruising and swelling after surgery. We always make sure our patients stop their blood thinners and things like that to make sure we decrease that, but anything that we can do afterwards to decrease their bruising and swelling, and get them back to their activities.
So healing more quickly?
Dr. Mack: Exactly, healing more quickly. I guess that’s the first question patients always ask. When can I get back to my activities? And obviously, the more bruising and swelling you have after surgery the longer it’s going to take to get back to their activities.
What is the hope with the goggles? What was the hope when you first went into this as a beta test?
Dr. Mack: Basically it’s actually a ski mask that the patient wears, during the day and nighttime. What the goggles do is they apply light pressure around the periorbital region. By doing that, they help with some of the leakage from the capillaries that happens during and after surgery. This will decrease the initial bruising and swelling and then patients will heal faster.
And what have you seen? Does it make a difference when compared to ice?
Dr. Mack: I think it really has. And I think the other thing that patients noticed, particularly when they’re sleeping with the goggles at nighttime is they’re going to protect the eyes. The patients describe also a cooling effect actually from the goggles. So they’re very comfortable. The center part of the goggles can be removed so you can actually see through the goggles. Typically, you wouldn’t want to do that until after the first 24 hours after surgery. The more compression you can get the better the result you’re going to get.
The first version of them, an earlier version didn’t have the eyeholes?
Dr. Mack: Correct, yeah.
What do the eyeholes allow?
Dr. Mack: Yeah what’s interesting is even when they changed the most recent version where they have the eyeholes in the center, I find most patients don’t even use it. They feel very comfortable. They almost describe a soothing effect after the surgery, almost a cooling effect from the goggles. I found particularly with my male patients who undergo eyelid surgery; men typically don’t follow directions after surgery as far as activity. So this really kind of keeps them in control. And I also mentioned at nighttime when patients are sleeping, you also have protection of the eyelids if they roll over on their pillow, things of that nature.
Right. So essentially, with the removable eye holes now, you still recommend they wear the full goggle with the eyehole in there the first night, right?
Dr. Mack: Exactly. Initially, you’re going to want to place gauze for any bruising directly after surgery. You wouldn’t have a benefit from taking out the center part. But the main compression is from the outer part of the ski mask, or the ski goggle.
So after a couple of days, if you want them to keep wearing the goggles for how long? Tell me what the process is.
Dr. Mack: The point of these Lid Lift Goggles was they function as a mechanism to decrease bruising and swelling after surgery. These were actually developed by a colleague of mine in Utah who actually took a ski goggle and converted it to use for the Lid Lift Goggles. Basically the goal is to decrease the bruising and swelling after surgery by decreasing some of the leakage from the capillaries after surgery. The patients will place them on immediately after surgery for about four hours. During the day, we ask the patients to wear them 80 percent of the time. We ask them to wear them for the first two nights and for the first three days, approximately three days altogether. The more they can wear them during the day, they can certainly take them off to eat and things of that nature during the day, but as much compression as we can get for those first three days, that’s really going to benefit the patient because the number one question all patients have when I’m speaking them preoperatively is, when can I get back to my activities? Whether it’s working, they’re retired, everybody has the same question. So this is a mechanism, particularly in my male patients, who may not follow directions, they may not take it easy as far as bending, lifting, straining after surgery, this offers just a great technique we can give these patients. I think once you get them past that first 72 hours with the bruising, they’re just going to heal that much faster.
Have you seen a big difference compared to ice?
Dr. Mack: I have. And I think one of the things in particular with my male patients is compliance. It sounds nice to say, tell your patients to do ice for their first couple of days. A lot of times, patients won’t follow directions. So I think this is a nice thing, they can apply the goggles. Interesting enough, they describe when they’re wearing the goggles, they have a cooling effect, and they’re very comfortable in them. The other thing that I like is when they’re wearing them at nighttime, it’s actually protecting the eyelid. So the last thing we want is for a patient to turn over and rub on their eyelids after surgery. This provides nice protection afterwards. They describe it as being very comforting afterwards.
How does it compare to before, what do patients usually do?
Dr. Mack: For that same time period, the first two to three days after surgery, we would recommend icing. Obviously, overnight, they’re not doing anything; they would do the icing during the day. So I think the other extra benefit is overnight, you’re getting that added compression and we’ve seen some excellent results.
What are some of the problems or obstacles that you faced with the goggles, any issues?
Dr. Mack: Obviously patients who are claustrophobic, we would ask them that beforehand. I’ve not personally had that with any of my patients, I myself ask the patients, did you have any problems wearing this for 80 percent of the time during the day? And interestingly enough, I have not had a patient who was concerned with that. They actually described this cooling effect or relaxed afterwards. But if a patient has a history of claustrophobia, obviously you wouldn’t want to use the goggles.
Are they uncomfortable? Did they complain about anything like that?
Dr. Mack: No, they’re pretty comfortable. They come with an adjustable band in the back so you can adjust it to the head circumference for comfort. But that has not been an issue.
And how has adding the eyehole helped?
Dr. Mack: You know, after the first day you can remove the center for the eyehole. I find most of the patients leave it in, but they do have that option.
I think during the day it gives them more flexibility.
Dr. Mack: Absolutely, yeah. They could certainly take it off if they wanted to watch TV. But most of the patients keep it on, though it’s certainly an option. It’s a modification they’ve made along the way with the Lid Lift Goggles.
Does wearing them any longer help?
Dr. Mack: I think wearing them for the first three days is sufficient.
If you wear them for two weeks, is it going to make the result better?
Dr. Mack: I think that’s a critical period. I do have some patients that may wear them at nighttime after the first three days, particularly to protect the eyes, I think that’s fine.
About how many patients have you had go through the process now? Have you seen quite a few?
Dr. Mack: I think we have probably around 30 to 35 patients.
And how do they compare to the ones using just ice?
Dr. Mack: I think they’re doing well. Like I said, we’ve used this particularly in male patients who don’t typically follow directions or patients who tell us they’re not going to use the ice afterwards. I think it’s a great choice.
And do you find that there is less bruising or expedited healing?
Dr. Mack: I believe there is less bruising and swelling.
When you compare ice to goggles, what would you recommend for patients? Is it just an option for comfort? Or is it actually healing time and everything?
Dr. Mack: I think that the patients who are compliant with the goggles, I do think they have decreased bruising and swelling. It would be interesting to see further studies down the road actually comparing the two. I think at that point, we could really help our patients make that decision.
And you’re just one of a handful of surgeons using the goggles or testing them?
Dr. Mack: Yes, I was the first surgeon in Florida. Now, since they released the product last summer, it’s been used throughout the United States. And I believe it’s been used in five or six other countries. So there are some international surgeons who are also starting to use the Lid Lift Goggles. I think that will help us as far as data collecting data on these patients.
What was it like to be one of the first?
Dr. Mack: I was very honored to be asked to be included in the initial studies, the initial analysis. And we of course discussed it with patients and gave them the option. I think it’s a great product.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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William Mack, MD
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