[Resection of the Müller muscle. Indications, technique and results]

Abstract

From 1987 to 1992, 582 operations for blepharoptosis were performed in our department. Twenty-five cases of superior tarsal muscle resection in 22 patients were reviewed retrospectively and serve as the basis of the present study. The blepharoptosis was mild to moderate (up to 4 mm) in 20/25 cases. Preoperatively, the phenylephrine eye drops test was positive in 20/25 cases. The indication for both congenital and acquired blepharoptosis was independent of the activity of the levator muscle. The resection was performed by a conjunctival approach. Three techniques of muscle stump refixation were tested without any significant difference in the results. A satisfactory eyelid elevation of more than 2 mm was achieved in 16/25 operations. A moderate effect (1-2 mm) was measured in 5/25 and an unsatisfactory effect (< 1 mm) in 4/25 cases. In contrast to the Fasanella-Servat procedure, the above-mentioned technique leaves all other structures of the upper eyelid intact, especially the accessory lacrimal glands.