Müller's muscle excision and levator recession in retracted upper lid. Treatment of thyroid-related retraction

The results of excision of Müller's muscle with or without recession of the levator palpebrae superioris aponeurosis were examined in 61 upper eyelids of 40 patients. The cosmetic results were acceptable in 35 patients (56 upper eyelids). Another five patients had a subsequent unilateral partial (nasal) or total ptosis, which was successfully treated with additional surgery. Overcorrections (ptosis) have ceased to be a problem since modifications to the original technique have been used. Only one undercorrection was encountered, and it was treated successfully with a simple surgical procedure. We believe that the described procedure is desirable for the treatment of thyroid-related upper eyelid retraction because it is simple, is based on anatomic and physiologic principles, is tailored to the individual patient intraoperatively and yields consistently good results.