| Title | External levator advancement vs Müller's muscle-conjunctival resection for correction of upper eyelid involutional ptosis. | | Author(s) | Ben Simon GJ, Lee S, Schwarcz RM, McCann JD, Goldberg RA | | Institution | Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA. guybensimon@gmail.com | | Source | Am J Ophthalmol 2005 Sep; 140(3):426-32. | | MeSH | Adult
Aged
Aged, 80 and over
Blepharoplasty
Blepharoptosis
Comparative Study
Conjunctiva
Esthetics
Eyelids
Female
Humans
Intraoperative Complications
Male
Middle Aged
Oculomotor Muscles
Postoperative Complications
Reoperation
Retrospective Studies
Treatment Outcome
| | Abstract | PURPOSE: To compare external levator advancement and Müller's muscle-conjunctival resection (conjunctivomullerectomy, or CJM) for correction of upper eyelid involutional ptosis.
DESIGN: Retrospective, nonrandomized, comparative interventional case series.
METHODS: Review of medical records of 159 patients (272 surgical procedures) who underwent external levator advancement or CJM was performed.
MAIN OUTCOME MEASURES: Functional and cosmetic outcome, marginal reflex distance one (MRD1), and surgical complications.
RESULTS: A total of 159 patients (51 men, 108 women, mean age 70 years) underwent 272 surgical procedures for upper eyelid ptosis; concurrent blepharoplasty was performed in 141 cases. MRD1 increased an average of 1.6 (+/-1.5) mm, from 0.8 mm (+/-1.2) preoperatively to 2.3 mm (+/-1.2) postoperatively (P < .001). Fifteen patients (5.5%) underwent reoperation for residual ptosis, nine (18%) in the external levator advancement group, two (3%) in the CJM group, three (8%) in the external plus blepharoplasty group, and one (1%) in the CJM plus blepharoplasty group (P < .001). Patients who underwent external levator advancement had significantly more severe ptosis preoperatively but attained similar eyelid position postoperatively as compared with CJM patients. Complications included overcorrection in four cases (1.4%), lagophthalmos of 1 mm in 10 (3.6%), and pyogenic granuloma in two (<1%).
CONCLUSIONS: External levator advancement and CJM performed alone or with concurrent blepharoplasty are effective treatments for upper eyelid ptosis. Residual ptosis or postoperative eyelid retraction occurs in up to 20% of cases and can be addressed successfully with a second operation. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16083839 |
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