title: Adrenergic receptors in the ptotic human eyelid: correlation with phenylephrine testing and surgical success in ptosis repair.
abstract: OBJECTIVE
  To investigate the relationship between adrenergic receptors in Müller muscle and response to phenylephrine testing in patients undergoing ptosis surgery. This study also compares outcomes of Fasanella and Putterman approaches to posterior ptosis repair.
  
  
  METHODS
  Prospective analysis of 71 patients undergoing posterior ptosis surgery. Eyelid height was measured before and after phenylephrine. Müller muscle was examined for alpha-1D, alpha-2C, beta-1, and beta-2 receptors. Specimens were graded on receptor staining intensity. Patients were seen 1 week and 6 weeks following surgery. Surgical outcomes were scored on a scale of 1 (most favorable) to 3 (least favorable).
  
  
  RESULTS
  Adrenergic receptors were found in decreasing order: alpha-1D, beta-1, alpha-2C, and beta-2. Receptor grade significantly predicted eyelid height for alpha-2C receptors (p = .03). Mean outcome scores for 36 Putterman (1.10) and 35 Fasanella (1.27) procedures were not significantly different.
  
  
  CONCLUSIONS
  Alpha 1D, alpha-2C, and beta-2 receptors are documented within human Müller muscle. Human eyelid elevation response to phenylephrine is inversely related to the amount of alpha-2C receptor staining in Müller muscle. Fasanella and Putterman procedures have equal outcomes, independent of adrenergic receptors.
authors: Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada.
authors: Bentley C
authors: BC
authors: Skibell
authors: John H
authors: JH
authors: Harvey
authors: James H
authors: JH
authors: Oestreicher
authors: David
authors: D
authors: Howarth
authors: Alison
authors: A
authors: Gibbs
authors: Trish
authors: T
authors: Wegrynowski
authors: Tony
authors: T
authors: Wing
authors: Dan D
authors: DD
authors: Deangelis
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty; D001763:Blepharoptosis / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D002648:Child; D005143:Eyelids / Q000378:metabolism*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism*; D010656:Phenylephrine; D011941:Receptors, Adrenergic / Q000378:metabolism*; D018340:Receptors, Adrenergic, alpha-1 / Q000378:metabolism; D018341:Receptors, Adrenergic, alpha-2 / Q000378:metabolism; D018342:Receptors, Adrenergic, beta-1 / Q000378:metabolism; D018343:Receptors, Adrenergic, beta-2 / Q000378:metabolism
chemical_list: C547719:ADRA1D protein, human; C547774:ADRA2C protein, human; D000316:Adrenergic alpha-Agonists; D011941:Receptors, Adrenergic; D018340:Receptors, Adrenergic, alpha-1; D018341:Receptors, Adrenergic, alpha-2; D018342:Receptors, Adrenergic, beta-1; D018343:Receptors, Adrenergic, beta-2; D010656:Phenylephrine