Clinical Study
Eye (2008) 22, 267–272; doi:10.1038/sj.eye.6702605; published online 8 December 2006
Isolated Muller's muscle resection for the correction of blepharoptosis
R Khooshabeh1 and H C Baldwin1
1Department of Opthalmology, Buckinghamshire Hospitals NHS Trust, Buckinghamshire, UK
Correspondence: R Khooshabeh, Department of Ophthalmology, Wycombe General Hospital, High Wycombe, Buckinghamshire HP1 12TT, UK. Tel: +44 1494 425890; Fax: +44 1494 431397. E-mail: khooshabeh@hotmail.com
Received 24 May 2006; Accepted 8 August 2006; Published online 8 December 2006.
Abstract
Purpose
To assess the outcome of isolated Muller's muscle resection with preservation of conjunctiva in patients with blepharoptosis and good to moderate levator function.
Methods
This study was designed as a prospective, nonrandomised case series. Thirty-four eyes of 27 blepharoptosis patients were operated on, who were phenylephrine test-negative as well as positive. Open-sky Muller's muscle resection was performed with preservation of the conjunctiva. Main outcome measures were increase in margin reflex distance (MRD1), eyelid contour, and symptoms and signs of dry eye.
Results
The mean increase in MRD1 was 2.75 mm. All but one patient (96%) had upper lid margins resting at or up to 1 mm below the limbus and obtained symmetry to within 0.5 mm of the fellow eye. No patients had symptoms or signs of dry eye.
Conclusion
Isolated Muller's muscle resection is effective for the correction of ptosis in patients with moderate to good levator function. This is irrespective of the lid's response to phenylephrine. Preservation of conjunctival tissue eliminates concerns about dry eye, and also preserves the full height of the fornix.
Keywords:
blepharoptosis, Muller's muscle, conjunctiva, dry eye
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