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A new algorithm for ptosis repair using conjunctival Müllerectomy with or without tarsectomy
Julian D Perry1, Anish Kadakia, Jill A Foster
1Department of Ophthalmic Plastic and Orbital Surgery, Division of Ophthalmology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. perryj1@ccf.org
Purpose:
To determine the predictability of a new algorithm for determining the amount of tissue resection for conjunctival Müllerectomy with or without tarsectomy blepharoptosis repair.
Methods:
Consecutive case series of all patients undergoing conjunctival Müllerectomy with or without tarsectomy ptosis repair from October 1999 to September 2001. Each patient underwent excision according to a new algorithm for determining the amount of tissue excision. The amount resected was determined by the following formula: 9 mm of conjunctiva and Müller muscle + x mm of tarsus, where x = distance of undercorrection after phenylephrine testing.
Results:
Sixty-eight consecutive patients underwent 70 cases of conjunctival Müllerectomy with or without tarsectomy ptosis repair on 117 eyelids, using a new algorithm for tissue excision. Forty-seven cases were bilateral and 23 were unilateral. Postoperative symmetry was found in 58 of 67 patients (87%) after 1 surgery. Patient satisfaction based on symmetry, contour, and height after 1 repair was achieved in 64 of 67 patients. There were no overcorrections. Two patients underwent successful reoperation with a second conjunctival Müllerectomy with or without tarsectomy operation.
Conclusions:
This modified algorithm and technique quantifies conjunctival Müllerectomy with or without tarsectomy ptosis surgery and yields predictable results.
