Müller muscle-conjunctiva resection to correct ptosis in high-risk patients.
OBJECTIVE
Müller muscle-conjunctiva resection could be seen as a relative contraindication in patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery. The concern centers around the theoretical risk of bleb-related complications or corneal damage from the palpebral conjunctival sutures. Our study aimed to determine whether any bleb- or cornea-related complications arose in patients who underwent Müller muscle-conjunctiva resection for ptosis correction.


METHODS
A retrospective chart review was performed on 2 practices of oculofacial plastic surgeons from 2000 to 2006, including patients who had ptosis correction by Müller muscle-conjunctiva resection. Patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery were identified. Each case was reviewed to determine whether any bleb- or cornea-related complications occurred. The postoperative improvement of ptosis measured by interpalpebral distance or margin reflex distance-1 also was noted.


RESULTS
Forty-three patients and 55 eyes with a history of a glaucoma filtering procedure (13 patients/15 eyes), corneal disease (1 patient/1 eye), or corneal surgery (29 patients/39 eyes) who underwent Müller muscle-conjunctiva resection were identified. The average follow-up time was 212.4 days. No bleb-related complications occurred. One patient with a history of Reis-Bücklers dystrophy experienced a corneal abrasion. Fifty-two of 55 patients had objective improvement of their ptosis.


CONCLUSIONS
Müller muscle-conjunctiva resection can provide an effective means for ptosis repair in patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery. One temporary postoperative corneal complication occurred in our series.
Michels
Kevin S
KS
Oregon Health and Science University, Portland, Oregon, USA.
Vagefi
M Reza
MR
Steele
Eric
E
Zwick
Orin M
OM
Torres
Jesus J
JJ
Seiff
Stuart R
SR
Dailey
Roger A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000209:etiology / Q000601:surgery*; D003228:Conjunctiva / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery; D005260:Female; D018463:Filtering Surgery; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors