Efficacy of the Muller Muscle-Conjunctival Resection for the Correction of Unilateral Ptosis following External Levator Operations in Patients with Bilateral Involutional Ptosis

Mangan M. S., Cakir A., Ercalik N. Y., Tekcan I., Balci S., Kose A. O., ...Daha Fazla

PLASTIC AND RECONSTRUCTIVE SURGERY, cilt.148, sa.2, 2021 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 148 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1097/prs.0000000000008190
  • Dergi Adı: PLASTIC AND RECONSTRUCTIVE SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Gender Studies Database, MEDLINE, MLA - Modern Language Association Database
  • İstanbul Üniversitesi Adresli: Evet

Özet

Patients with aponeurotic blepharoptosis who are treated with external levator advancement may experience complications such as upper eyelid height asymmetry and often require revision surgery. The authors assessed the efficacy of Muller muscle-conjunctival resection in cases with upper eyelid height asymmetry following bilateral external levator advancement. The authors used retrospective analysis of 11 cases between September of 2016 and October of 2018 with eyelid asymmetry following bilateral external levator advancement. Following a positive phenylephrine test, these patients underwent unilateral Muller muscle-conjunctival resection revision surgery to treat the undercorrected eyelid. Preoperative and postoperative marginal reflex distance 1, symmetry outcomes, and clinical outcomes of patients were evaluated after the Muller muscle-conjunctival resection. The average patient age was 54.81 +/- 3.95 years (range, 37 to 69 years; median, 56 years); seven patients (63.6 percent) were women. Hering dependency was seen in all patients before the external levator advancement. A total of three patients underwent bilateral external levator advancement simultaneously, and eight patients underwent bilateral external levator advancement sequentially. The phenylephrine test was positive in all patients before the Muller muscle-conjunctival resection. Symmetry outcomes were assessed after the revision surgery as perfect (<0.5 mm), good (>= 0.5 to <1 mm), or fair (>= 1 mm) in four patients, six patients, and one patient, respectively. An optimal correction was noted in 13 of the 22 eyelids after the revision surgery, whereas eight of the 22 eyelids had minimal undercorrection, and one eyelid had minimal overcorrection. Muller muscle-conjunctival resection revision surgery for treatment of the ptotic eyelid following bilateral external levator advancement is viable and may represent a new alternative among the limited revision techniques.