Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 21;22(1):377.
doi: 10.1186/s12886-022-02605-6.

Effect of Muller's muscle-conjunctival resection on the upper eyelid crease position in Asian eyelids: a retrospective cohort study

Hung-Ju Chen  1 , Chun-Yuan Wang  1 , Yu-Fang Huang  1 , Yu-Chieh Wu  1 , Li-Chen Wei  2
Affiliations

Effect of Muller's muscle-conjunctival resection on the upper eyelid crease position in Asian eyelids: a retrospective cohort study

Hung-Ju Chen et al. BMC Ophthalmol. .

Abstract

Purpose: Investigating the effect of Muller's muscle-conjunctival resection (MMCR) on the eyelid crease position.

Methods: This retrospective study included patients with unilateral acquired blepharoptosis who underwent MMCR during October 2018-December 2021. The following factors were recorded: preoperative, after phenylephrine, postoperative marginal reflex distance1 (MRD1) and tarsal platform show (TPS) of bilateral eyelids. The primary outcome was to measure the change in TPS and evaluate the factors associated with post-operative TPS. The secondary outcomes included exploring the rate of MRD1 and TPS symmetry after the operation.

Results: Forty patients were included in the final analysis. The mean MRD1 of the ptotic eye was 1.28 ± 0.78 mm, 2.79 ± 0.66 mm and 3.20 ± 0.67 mm before, after phenylephrine and after the operation, respectively. The mean TPS of the ptotic eye was 5.90 ± 1.86 mm, 3.96 ± 1.49 mm and 2.79 ± 1.63 mm before, after phenylephrine and after the operation, respectively. Changes in mean TPS after the phenylephrine test and post-operation were statistically significant (p < 0.001). The linear regression model revealed that the absolute change in TPS after phenylephrine drop and absolute change in MRD1 post-operation were significantly correlated with the absolute change in TPS post-operation. Besides, the ratio of symmetry in MRD1 and TPS was greatly improved post-operation (82.5% and 70.0% respectively).

Conclusion: MMCR is an effective surgical method for ptosis correction as it can not only correct the eyelid crease position but also narrow the wide TPS. This method is particularly beneficial to patients with both mild to moderate ptosis and an asymmetric crease height.

Keywords: Blepharoptosis; Crease height; Marginal reflex distance; Müllerectomy; Tarsal platform show.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
a Mean MRD1 of ptotic eye before operation, after phenylephrine and after operation. b Mean TPS of ptotic eye before operation, after phenylephrine and after operation. MRD1 = marginal reflex distance1; TPS = tarsal platform show
Fig. 2
Fig. 2
a Pearson correlation tests between the absolute change of TPS after operation and the absolute change of TPS after phenylephrine test. b Pearson correlation tests between the absolute change of TPS after operation and the absolute change of MRD1 after operation. TPS = tarsal platform show; MRD1 = marginal reflex distance1
Fig. 3
Fig. 3
a The symmetry rate of MRD1 before, after phenylephrine drop, after operation. b The symmetry rate of TPS before, after phenylephrine drop, after operation. MRD1 = marginal reflex distance1; TPS = tarsal platform show
Fig. 4
Fig. 4
a Preoperative MRD1 and TPS difference (b) MRD1 and TPS difference after phenylephrine test (c) MRD1 and TPS difference after MMCR. MRD1 = marginal reflex distance1; TPS = tarsal platform show
See this image and copyright information in PMC

References

    1. Sridharan GV, Tallis RC, Leatherbarrow B, Forman WM. A community survey of ptosis of the eyelid and pupil size of elderly people. Age Ageing. 1995;24(1):21–24. doi: 10.1093/ageing/24.1.21. - DOI - PubMed
    1. Hashemi H, Khabazkhoob M, Emamian MH, Yekta A, Jafari A, Nabovati P, Fotouhi A. The prevalence of ptosis in an Iranian adult population. J Curr Ophthalmol. 2016;28(3):142–145. doi: 10.1016/j.joco.2016.04.005. - DOI - PMC - PubMed
    1. Kim MH, Cho J, Zhao D, Woo KI, Kim YD, Kim S, Yang SW. Prevalence and associated factors of blepharoptosis in Korean adult population: The Korea national health and nutrition examination survey 2008–2011. Eye (Lond) 2017;31(6):940–946. doi: 10.1038/eye.2017.43. - DOI - PMC - PubMed
    1. Lee YG, Son BJ, Lee KH, Lee SY, Kim CY. Clinical and demographic characteristics of blepharoptosis in Korea: A 24-year experience including 2,328 patients. Korean J Ophthalmol. 2018;32(4):249–256. doi: 10.3341/kjo.2017.0118. - DOI - PMC - PubMed
    1. Putterman AM, Urist MJ. Müller muscle-conjunctiva resection: technique for treatment of blepharoptosis. Arch Ophthalmol. 1975;93(8):619–623. doi: 10.1001/archopht.1975.01010020595007. - DOI - PubMed

LinkOut - more resources