The Utility of Preoperative Phenylephrine Testing in Müller Muscle Conjunctival Resection Surgery for Involutional...

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Outcomes

Background:

• Phenylephrine testing is traditionally used to predict outcomes for Müller muscle conjunctival resection.
• Involutional ptosis affects eyelid position and is often treated with surgical correction.

Purpose of the Study:

• To determine if preoperative phenylephrine testing impacts postoperative eyelid position changes after Müller muscle conjunctival resection.
• To evaluate the predictive value of phenylephrine testing for surgical outcomes in ptosis repair.

Main Methods:

• A multicenter cross-sectional cohort study involving 270 eyelids with involutional ptosis and good levator function.
• Participants were divided into groups with and without preoperative phenylephrine testing.
• The primary outcome was postoperative marginal reflex distance 1 (MRD1); secondary outcomes included change in MRD1 and reoperation rates.

Main Results:

• No significant difference in postoperative MRD1 or change in MRD1 was observed between groups (p > 0.05).
• Preoperative phenylephrine testing correctly predicted postoperative MRD1 within 1 mm in 60.2% of cases.
• Levator function and resection length showed no significant differences between the groups.

Conclusions:

• Preoperative phenylephrine testing does not significantly predict postoperative eyelid elevation in Müller muscle conjunctival resection.
• The utility of preoperative phenylephrine testing in predicting surgical outcomes for ptosis may need reassessment.
• Surgeons can consider alternative methods for predicting outcomes in ptosis surgery.