Impact of phenylephrine-induced Hering's response on Müller's muscle-conjunctival resection outcomes

To evaluate the impact of preoperative phenylephrine (PE)-induced Hering's response on postoperative outcomes in patients undergoing unilateral Müller's muscle-conjunctival resection (MMCR) for blepharoptosis correction.

Sixty-five consecutive patients (65 eyes) undergoing unilateral MMCR between January 2016 and December 2023 were included in this retrospective single-surgeon study. The main outcome measure was the margin-reflex distance 1 (MRD1) at postoperative month 1 visit. Logistic regression analysis was conducted to identify factors influencing postoperative Hering's response.

A preoperative post-PE Hering's response was observed in 40.0% of patients. At 1 week and 1 month postoperatively, Hering's response was recorded in 20.0% and 21.5% of cases, respectively. Regression analysis revealed a significant correlation between preoperative post-PE Hering's and post-MMCR Hering's response at postoperative month 1 visit (crude odds ratio (OR): 8.80, p = .003; adjusted OR: 30.43, p = .002).

Preoperative post-PE Hering's response is a significant predictor of postoperative Hering's response in unilateral MMCR.