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The Wonder of Sutureless Müllerectomy.

Maya Atar-Vardi, Biana Dubinsky-Pertzov, Shir Butnik-Cohen

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    |June 27, 2025
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    Summary

    Sutureless Muller muscle-conjunctival resection (MMCR) effectively treats ptosis with high success and symmetry rates. This minimally invasive approach offers a safe alternative to traditional sutured procedures, reducing complication risks.

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    Area of Science:

    • Ophthalmology
    • Oculoplastics
    • Surgical Innovation

    Background:

    • Muller muscle-conjunctival resection (MMCR) is a treatment for ptosis.
    • Sutured MMCR can lead to corneal complications.
    • Sutureless techniques aim to mitigate these risks.

    Purpose of the Study:

    • Evaluate the efficacy and safety of sutureless MMCR for moderate to severe ptosis.
    • Assess postoperative eyelid symmetry and surgical success rates.
    • Compare outcomes with phenylephrine response.

    Main Methods:

    • Retrospective, single-center cohort study of 147 patients (252 eyes).
    • Sutureless MMCR performed on patients with positive phenylephrine response.
    • Margin-reflex distance 1 (MRD1) measured pre- and post-operatively at multiple time points.

    Main Results:

    • 88.5% surgical success rate (postoperative MRD1 ≥3 mm or ±0.5 mm of phenylephrine MRD1).
    • 93.3% symmetry achieved in bilateral cases.
    • Minimal complications (1.19% wound dehiscence); female patients showed higher success.

    Conclusions:

    • Sutureless MMCR is effective and safe for ptosis treatment.
    • Achieves high success rates and excellent eyelid symmetry.
    • Represents a reliable, minimally invasive surgical option.