An Alternative Algorithm for Müller Muscle Conjunctival Resection Surgery for Blepharoptosis Management

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Techniques

Background:

• Mild ptosis (≤2 mm) with good levator function (≥8 mm) often requires surgical correction.
• Phenylephrine testing is a common method to predict surgical outcomes for ptosis.
• Müller muscle conjunctival resection (MMCR) is an alternative to external approaches for ptosis repair.

Purpose of the Study:

• To evaluate the surgical outcomes of Müller Muscle conjunctival resection (MMCR) using an alternative formula.
• To assess the predictability and success rate of MMCR in patients with mild ptosis.

Main Methods:

• Retrospective review of 58 eyes of 58 patients undergoing MMCR for mild ptosis.
• Phenylephrine testing used to guide the amount of conjunctival resection (8-10 mm).
• Margin-reflex distance 1 (MRD1) and Schirmer test measurements pre- and post-operatively (1, 3, 6 months).

Main Results:

• Statistically significant increase in MRD1 at 1, 3, and 6 months post-surgery (p<0.05).
• High postoperative symmetry achieved in 93.1% of patients at 6 months.
• No statistically significant changes in Schirmer test results; no adverse events like keratopathy or symblepharon reported.

Conclusions:

• Müller muscle conjunctival resection (MMCR) is a viable alternative surgical approach for mild ptosis with good levator function.
• The specific algorithm employed in this study yielded a high success rate and predictability.
• MMCR offers a predictable and effective surgical solution, minimizing complications.