title: Conjunctiva-Sparing Posterior Ptosis Surgery: A Novel Approach.
abstract: OBJECTIVE
  Müller's muscle conjunctiva resection is a well-established means of correcting blepharoptosis. The primary objective of this prospective study was to determine if modifying Müller's muscle conjunctiva resection by sparing the conjunctiva would accomplish successful repair while allowing patients to retain their conjunctiva. The potential advantages of preserving conjunctiva are significant and include: conservation of an anatomically normal tissue, retention of goblet cells, reduction of suture-related complications such as corneal irritation or abrasion as the conjunctiva covers the suture during postoperative healing, and preservation of conjunctiva for potential future surgical procedures critical to ocular health.
  
  
  METHODS
  This is a prospective study enrolling patients with mild to moderate ptosis.
  
  
  RESULTS
  The procedure has been performed in 18 patients and 30 eyelids. Follow up at 1 week revealed normal healing with expected postoperative edema and ecchymosis. Notably, all patients were free of any corneal abrasion or irritation. Follow up at 1 month and a minimum of 3 months (average 5.7 months) revealed that all patients had satisfactory correction of their blepharoptosis with Margin Reflex Distance 1 (MRD1) improvement to within 1 mm of the anticipated goal, preserved eyelid margin contour, and good symmetry (average 0.26 mm difference in MRD1 between the sides).
  
  
  CONCLUSIONS
  These results show an effective correction of blepharoptosis with a favorable cosmetic outcome and low postoperative complication rate; all while preserving the conjunctiva.
authors.affiliation: *Department of Ophthalmology, and †Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, U.S.A.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vrcek
authors.forename: Robert N
authors.initials: RN
authors.lastname: Hogan
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rossen
authors.forename: Ronald
authors.initials: R
authors.lastname: Mancini
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000601:surgery*; D003228:Conjunctiva / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D011446:Prospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome