Efficacy of Transconjunctival Tucking Surgery in Comparison With the Phenylephrine-test Positive and Negative...

This study aimed to determine whether there is a significant difference in the efficacy of transconjunctival tucking of the Müller muscle and levator aponeurosis in patients with involutional blepharoptosis who tested positive or negative on the phenylephrine test.

The analysis involved 64 eyes of 42 patients with levator muscle function of the upper eyelid of 8 mm or more and a margin reflex distance 1 (MRD-1) of less than 2 mm. Patients who tested positive and negative for 5% phenylephrine were allocated to group A (41 eyes of 26 patients) and group B (23 eyes of 16 patients), respectively. The efficacy of surgery (ΔMRD-1) was compared by subtracting preoperative MRD-1 from postoperative MRD-1. Multiple comparison tests were performed to evaluate changes in MRD-1 and ΔMRD-1 every 3 months from 3 to 12 months after transconjunctival tucking of the Müller muscle and levator aponeurosis.

Regarding the mean ΔMRD-1 values at 3, 6, and 12 months postoperatively, the values at 6 and 12 months were significantly lower in group A than in group B, with 2.31, 1.98, and 1.81 mm, respectively, in group A and 2.73, 2.71, and 2.50 mm, in group B (P = 0.03 at 6 mo and P = 0.041 at 12 mo).

The efficacy of transconjunctival tucking of the Müller muscle and levator aponeurosis was greater in group B than in group A, and the results were more stable. This is an interesting finding when considering the successful mechanism in the present surgical method.