September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparative Analysis of Eyelid Contour Changes in Müller’s Muscle Conjunctival Resection and External Levator Resection Ptosis Surgery
Author Affiliations & Notes
  • Daniel Rootman
    Ophthalmology, UCLA, Los Angeles, California, United States
  • Jennifer Danesh
    Ophthalmology, UCLA, Los Angeles, California, United States
  • Robert Goldberg
    Ophthalmology, UCLA, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Daniel Rootman, None; Jennifer Danesh, None; Robert Goldberg, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 716. doi:
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    • Get Citation

      Daniel Rootman, Jennifer Danesh, Robert Goldberg; Comparative Analysis of Eyelid Contour Changes in Müller’s Muscle Conjunctival Resection and External Levator Resection Ptosis Surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):716.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Although Müller’s Muscle Conjunctival Resection (MMCR) and External Levator Resection (ELR) are widely utilized to manage ptosis, there is little direct comparative data regarding outcomes. Further, there is a dearth of available data concerning objective or quantitative assessment of eyelid contour results. This study aims to assess relative changes in upper eyelid contour for patients undergoing MMCR and ELR surgery.

Methods : In this retrospective cohort study, 20 eyes of 10 patients who underwent MMCR and 20 eyes of 16 patients who underwent ELR in a single center were included. Patients with history of previous or concurrent eyelid surgery or orbital disease were excluded. Primary position photographs were obtained pre-operatively and >3 months postoperatively. Processing and measurement of the digital photos with public domain NIH ImageJ software proceeded as follows. Images were rotated in order that a line intersecting the lateral canthi was made parallel to the horizontal axis. The center of the pupil was then defined as the 0,0 coordinate. Images were calibrated using a standard corneal diameter for males and females respectively. Along the x-axis,10 points were defined:at the center of the pupil and at 2mm intervals laterally to 10mm and medially to 8mm(Figure 1). This was performed at baseline and postoperative photographs. One-way and repeated measures ANOVA were performed

Results : The overall main effect of position was significant(p<0.05) indicating there is variation in vertical height across the eyelid. The effect of time was also significant(p<0.05) indicating that the vertical height of the eyelid changed with surgery. When assessing individual point differences between groups, there was a significant interaction effect of group on time at the nasal-most positions of 6 and 8mm(p<0.05), with a trend at 4mm(p<0.07), indicating a greater change with MMCR at these positions(Figure 2a). Comparing change in height at each point across the two groups revealed MMCR to have greater change at positions N4, N6 and N8(p<0.05) (Figure 2b).

Conclusions : Both MMCR and ELR are effective in elevating the eyelid. Relative to ELR, there is a small but significant bias towards increased vertical elevation medial to the center of the pupil in the MMCR group. This suggests that there may be a relative medial bias with MMCR, or conversely a lateral bias with ELR.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

 

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