title: Open sky Müller muscle-conjunctival resection in phenylephrine test-negative blepharoptosis patients.
abstract: OBJECTIVE
  To assess the efficacy of Müller muscle-conjunctival resection in patients in whom the phenylephrine test was negative.
  
  
  METHODS
  A non-randomized, prospective clinical trial was conducted on 20 eyelids of 15 consecutive patients with blepharoptosis who showed no change in the upper eyelid margin-reflex distance (MRD1) following instillation of topical phenylephrine. The technique used was open sky Müller muscle-conjunctival resection.
  
  
  RESULTS
  The mean MRD1 increased by 3.3 mm. No patient required augmentation of the procedure, and all patients had excellent appearance of their skin crease and eyelid contour. No complications arose from the procedure, including no incidence of dry eye symptoms or signs.
  
  
  CONCLUSIONS
  Müller muscle-conjunctival resection may offer a safe and effective means of treating blepharoptosis despite a negative phenylephrine test.
authors.affiliation: Buckinghamshire Hospitals NHS Trust, Stoke Mandeville and Wycombe General Hospitals. baldwintanner@aol.com
authors.forename: Heather C
authors.initials: HC
authors.lastname: Baldwin
authors.forename: Joy
authors.initials: J
authors.lastname: Bhagey
authors.forename: Ramona
authors.initials: R
authors.lastname: Khooshabeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D002675:Child, Preschool; D003228:Conjunctiva / Q000601:surgery*; D003941:Diagnostic Techniques, Ophthalmological; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D010656:Phenylephrine; D011446:Prospective Studies; D013566:Sympathomimetics
chemical_list: D013566:Sympathomimetics; D010656:Phenylephrine