Purpose
To demonstrate predictability and outcomes with conjunctiva Muller muscle resection (CMR) for blepharoptosis repair using a new algorithm.
Methods
Retrospective review of 105 patients and 182 eyelids that underwent CMR at one site with a single surgeon. 77 women and 28 men aged between 25-90 years old. Measured endpoints included pre and post-operative MRD1, symmetry, complication rates and symptomatic dry eye post-operatively. Patients were followed for a 12 month post-operative period.
Results
Pre-operative MRD1 ranged between -3 to +3 mm with a mean of 0.6 mm. Post-operative MRD1 ranged between 1 to 4.5 mm with a mean of 2.6 mm. 95.1% of patients had symmetry up to 1 mm and 89% up to 0.5 mm. 17.6% patients were undercorrected. 11.5% of patients were overcorrected. 1% of patients sustained a corneal abrasion post-operatively. Patients with glaucoma filtering blebs had no post-operative complications.
Conclusions
Using a new algorithm, this modified CMR technique is highly reliable and predictable. It is an effective treatment for mild to severe ptosis; it does not worsen dry eye symptoms; and it can be using safely in the presence of glaucoma filtering blebs. Other advantages of CMR include preservation of natural eyelid contour and the ability to perform this procedure under general anesthesia.