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J. Abbasian, R. Vasaiwala, P. Setabutr, A. Putterman, K. Sajja; Müller’s Muscle-Conjunctival Resection Procedure for the Treatment of Moderate Blepharoptosis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4824.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of Müller’s muscle-conjunctival resection procedure for the treatment of moderate blepharoptosis, defined as upper lid deviation greater than 2 millimeters.
Retrospective chart review including patient encounters between January 2004 and February 2008 identified 128 patients (206 lids) who underwent unilateral or bilateral Müller’s muscle-conjunctival resection for the treatment of blepharoptosis. Inclusion criteria defined as presenting preoperatively with greater than 2 millimeters of blepharoptosis (moderative blepharoptosis) from an ideal upper lid position (margin to reflex distance [MRD1] of 3 millimeters). Exclusion criteria included patients who underwent Müller’s muscle-conjunctival resection procedure for minimal blepharoptosis (≤ 2 millimeters) and patient’s second upper lid, in bilateral cases, that did not meet inclusion criteria.
Of the 206 lids examined with >2 mm ptosis (n=206), the average preoperative MRD1 was -0.24 mm with posteroperative MRD1 of 3.13 mm. The subgroup of blepharoptosis >3mm (n=72) had preoperative MRD1 measuring -1.3 mm with a postoperative MRD1 of 2.9 mm. The subgroup with blepharaoptosis >4 mm (n=33) had average preoperative MRD1 of -1.86 mm and a posteroperative MRD1 of 3.07 mm. The final group of patients with blepharoptosis > 5 mm (n=5) had preoperative MRD1 of -2.25 mm and a postoperative MRD1 of 2.75 mm. The above results were found to be statistically significant with a P value < 0.0001.
Patients with moderate blepharoptosis undergoing Müller’s muscle-conjunctival resection procedure have significant improvement in upper lid position and symmetry. Additionally, patients with moderate blepharoptosis can benefit greatly from a Müller’s muscle-conjunctival resection procedure as it is easily combined with blepharoplasty or tarsal strip surgery with good results. The Müller’s muscle-conjunctival resection procedure is further favored for decreased operative time and recovery time as compared to conventional strategy (external levator advancement) and should strongly be considered in the treatment of moderate blepharoptosis.
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