[The Müller-ectomy in endocrine orbitopathy]

Area of Science:

• Ophthalmology
• Oculoplastic Surgery

Context:

• Thyroid ophthalmopathy commonly leads to significant upper and lower eyelid retraction.
• Eyelid retraction can cause corneal exposure and necessitates corrective surgical procedures.
• Cosmetic disfigurement and functional impairment are common in affected patients.

Purpose:

• To evaluate the efficacy of the transconjunctival Mueller ectomy with mechanical disinsertion of the levator muscle for correcting eyelid retraction in thyroid ophthalmopathy.
• To assess the cosmetic and functional outcomes of this surgical technique.

Summary:

• The Mueller ectomy technique, involving mechanical disinsertion of the levator muscle, was performed on ten patients with thyroid ophthalmopathy.
• The procedure resulted in an average upper eyelid lowering of 5.0 mm.
• While generally successful, complications included temporal upper eyelid flare (3 cases) and postoperative ptosis (1 case).

Impact:

• Transconjunctival Mueller ectomy offers good cosmetic and functional results for significant upper eyelid retraction.
• This approach avoids external scarring and preserves external lid structures, facilitating potential revisions via external incisions.
• The technique provides a viable surgical option for managing eyelid retraction in thyroid eye disease.