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KMID : 0360220170580060627
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Journal of the Korean Ophthalmological Society
2017 Volume.58 No. 6 p.627 ~ p.633
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Eyelid Contour Analysis Following Muller’s Muscle-conjunctival Resection and Levator Aponeurosis Advancement in Mild to Moderate Belpharoptosis
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Lee Sang-Min
Lew He-Len
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Abstract
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Purpose: To analyze both the effects and the eyelid contour of Muller’s muscle-conjunctival resection and levator aponeurosis advancement in patients with mild to moderate belpharoptosis.
Methods: We conducted a retrospective cross-sectional study including 20 eyes of 16 patients who underwent Muller’s muscle- conjunctival resection and 25 eyes of 17 patients who underwent levator aponeurosis advancement from January 2012 to December 2015, where each patient was followed up for at least 6 months. Surgical success was defined as either a marginal reflex distance 1 (MRD1) elevation greater than 2.5 mm postoperatively or a bilateral MRD1 difference less than 0.5 mm. Both the conventional and 12 oblique mid-pupil lid distances were measured every 15 degrees using custom software developed in the MATLAB program (MathWorks, Natick, MA, USA).
Results: The average correction of Muller’s muscle-conjunctival resection was 1.1 mm, while that of levator aponeurosis advancement was 0.9 mm. There was no significant difference in MRD1, MRD2, function of levator palpebrae muscle, or lid contour in the preoperative status between the Muller’s muscle-conjunctival resection group and the levator aponeurosis advancement group. The surgical success rate was 85% in the Muller’s muscle-conjunctival resection group and 84% in the levator aponeurosis advancement group, but this difference was not significant. The postoperative lid contour (superomedial side, 15°) was more effective in the Muller’s muscle-conjunctival resection group (p < 0.05).
Conclusions: Overall, both types of blepharoptosis surgery were effective at correcting mild to moderate blepharoptosis. The correction of mild to moderate blepharoptosis using Muller’s muscle-conjunctival resection is an effective technique for elevating the eyelid and normalizing the eyelid contour.
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KEYWORD
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Blepharoptosis, Eyelid contour, Levator aponeurosis advancement, Muller’s muscle-conjunctival resection
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