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V. Kulchaiyawat, V. K. Aakalu, K. Sajja, S. Gupta, J. Hallak, P. Setabutr; A Clinicopathological Correlation Between Müller's Muscle-Conjunctival Resection and Corneal Staining Pattern. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1472.
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To determine if Müller’s muscle-conjunctival resection (MMCR) worsens corneal staining postoperatively and to investigate an association between corneal staining and excision of accessory lacrimal gland (ALG) tissue during MMCR.
A database of 123 patients that underwent MMCR between January 2001 and July 2009 was reviewed. The charts of patients with pathology specimens of resected tissues were analyzed. Demographics (age, sex), ocular history, and amount of tissue resected were recorded. The presence or absence of ALG in pathologic specimens was documented. Corneal staining pattern and lagophthalmos were recorded preoperatively, 1 week, and 1 month postoperatively. Data were analyzed using SAS (SAS Institute) software.
Twenty-five patients with 35 eyelid specimens (15 women, mean age 53 years) underwent MMCR and had resected tissues sent to pathology. ALG was detected in twenty specimens. The amount of tissue resected ranged between 6.5-9.5 mm. After 1 week follow up, 23% of eyes had worsening of corneal staining, 77% had no change or improvement in corneal staining pattern. After 1 month follow up, 10% exhibited worsening and 90% had no change or improvement in corneal staining pattern. Lagophthalmos was found in 18% of eyes 1 week postoperatively, which showed no statistical significant difference to worsened corneal staining (p=0.602). However, lagophthalmos was found in 19% of eyes 1 month postoperatively and was associated with worsening corneal staining (p=0.004). When assessed in a multivariate regression model, no significant effect of lagophthalmos on worsening of corneal staining was found. There was no statistically significant association between worsening of corneal staining pattern 1 week or 1 month postoperatively with the excision of ALG (p=0.10 and p=1.00 respectively).
Resection of accessory lacrimal glands during MMCR does not predict worsening of corneal staining postoperatively and there was no noted association of MMCR with worsening corneal staining postoperatively.
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