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An Alternative Algorithm for Müller Muscle Conjunctival Resection Surgery for Blepharoptosis Management
Gamze Ozturk Karabulut, Korhan Fazıl, Orcun Sonmez, Zehra Karaağaç Günaydın, Kubra Serefoglu Cabuk, Isil Pasaoglu, Muhittin TaskapiliDepartment of Oculoplastic Surgery, University of Health Sciences, Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, TurkeyINTRODUCTION: To evaluate the surgical outcomes of Müller Muscle conjunctival resection surgery performed with an alternative formula.
METHODS: A total of 58 eyes of 58 patients with mild ptosis (≤2 mm) and levator function ≥8 mm who responded to 2.5% phenylephrine were enrolled in this study. Müller muscle conjunctival resection was performed between March 2016-March 2018, and the charts were reviewed retrospectively. Margin-reflex distance 1 was measured before and after five minutes following the instillation of phenylephrine. The amount of excision was 9 mm when the desired elevation was achieved. If the phenylephrine testing resulted in under-correction, 10 mm was resected, and in overcorrection, 8 mm resection was performed. Margin reflex distance and Schirmer test measurements were performed preoperatively and on the first, third and sixth months postoperatively.
RESULTS: The mean increase in margin-reflex distance 1 was statistically significant at the first, third and sixth months postoperatively when compared to preoperative values (p<0.05, Wilcoxon signed ranks test). Postoperative symmetry was achieved in 54 patients (93.1%) after six months. Compared to the preoperative values, changes in Schirmer-1 test results were not statistically significant at each visit after the procedure (p>0.05, Wilcoxon signed ranks test). None of the patients had keratopathy, eyelid contour abnormality, or symblepharon.
DISCUSSION AND CONCLUSION: Müller muscle conjunctival resection is an alternative procedure to external approach in patients with mild ptosis and good levator function. The algorithm used in this study resulted in a high success rate with high predictability.
Manuscript Language: English
