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D. Sakamoto, M.E. Hartstein, M.S. Brown; Muller's Muscle–Conjunctival Resection Ptosis Repair in Patients Wearing Rigid Gas Permeable Lenses . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5605.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The upper eyelid plays a crucial role in successful fitting of rigid gas permeable (RGP) contact lenses. Alterations to upper eyelid position such as in blepharoptosis repair can adversely affect this crucial lens–lid relationship. Muller's muscle–conjunctival resection (MMCR) and levator advancement surgical approaches were compared in patients with acquired blepharoptosis and visually dependent on RGP lenses. Methods: We retrospectively reviewed the records of patients with a history of both RGP lens wear for vision correction and blepharoptosis repair between January 1998 and November 2003. Results: There were 16 patients (27 eyelids) who wore RGP lenses and had surgical ptosis correction. Ten patients (15 eyelids) underwent Muller's muscle–conjunctival resection and 6 patients (12 eyelids) underwent levator advancement. All patients but one were female RGP lens wearers and their age ranged from 40 to 75 years. All patients were followed for at least three months. After Muller's muscle–conjunctival resection for acquired blepharoptosis, all nine patients had successful ptosis repair and were able to return to RGP lens wear within 2 weeks of surgery, without need for any lens fit adjustment. All six patients that underwent ptosis repair by levator advancement had successful ptosis correction, but either had delayed return to RGP lens wear or needed to be refit. Also, final lid height was more predictable in the MMCR group. Conclusions: Our experience suggests that Muller's muscle–conjunctival resection is a safe and effective procedure in patients wearing RGP lenses, does not disturb RGP lens fit, and yields a more predictable lid height.
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