Full-thickness Eyelid Defect Immediately After Müller Muscle-Conjunctival Resection

Area of Science:

• Ophthalmology
• Surgical Complications

Background:

• Müller muscle-conjunctival resection (MMCR) is a common surgical procedure for treating aponeurotic ptosis.
• MMCR is generally considered safe with a low rate of complications.

Purpose of the Study:

• To report a rare, previously undocumented complication of MMCR: a full-thickness eyelid defect.
• To highlight the importance of meticulous surgical technique and postoperative care.

Main Methods:

• A 63-year-old male patient with unilateral aponeurotic ptosis underwent MMCR.
• A 9 mm resection was performed using a Putterman clamp.
• Postoperative monitoring identified a full-thickness eyelid defect on postoperative day 10.

Main Results:

• The patient developed a 7 mm horizontally and 5 mm vertically sized full-thickness eyelid defect.
• The defect was most noticeable during downgaze and not apparent when eyes were closed or in primary position.
• Revision surgery resulted in complete functional and cosmetic recovery.

Conclusions:

• Meticulous intraoperative technique during MMCR is crucial.
• Vigilant postoperative monitoring is essential to detect rare complications like full-thickness eyelid defects.
• Even minimally invasive procedures require careful attention to avoid significant adverse events.