Chemosis following blepharoplasty: an unusual complication

We observed four cases of chemosis associated with otherwise uneventful four-lid blepharoplasty. These patients experienced postoperative conjunctival chemosis (without associated globe injection), varied types of congestion, subconjunctival hemorrhage, retrobulbar hematoma, or corneal involvement. Postoperatively, the patients were treated with some combination of patching, topical and/or systemic steroids, decongestant eye drops, and observation. Regardless of the treatment, the chemosis resolved by 5 months, without permanent complication. Probable causes were blockage of orbital or eyelid lymphatics and excessive cautery during surgery.