The Wonder of Sutureless Müllerectomy

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.