Bruna L. Rymer, Diane R. Marinho, Cristina Cagliari, Samara B. Marafon, Fernando Procianoy. Effects of Muller’s muscle-conjunctival resection for ptosis on ocular surface scores and dry eye symptoms. Journal Orbit: The International Journal on Orbital Disorders, Oculoplastic and Lacrimal Surgery. Volume 36, 2017 – Issue 1.
Muller’s muscle-conjunctival resection (MMCR) is an interesting and well established technique for acquired mild ptosis.
However, controversy remains among surgeons as to the consequences of MMCR to the ocular surface and dry eye symptoms. We decided to study if this change actually occurs and is significant.
In our study, we performed a subjective ( with the Salisbury Eye Evaluation questionnaire) and an objective ( with Shirmmer’s test, tear break-up- TBUT- time, fluorescein and rose bengal staining) evaluation of ocular surface before and after Muller’s muscle-conjunctival resection.
Patients had dermatochalasis with or without associated ptosis.Those with superior margin reflex distance (MRD1) ≥3 mm underwent bilateral upper eyelid blepharoplasty with skin-only excision (control group). Patients with MRD1 < 3 underwent bilateral upper eyelid blepharoplasty combined with Muller’s muscle-conjunctival resection.
We had the following results: There was a significant reduction in dry eye questionnaire scores when comparing the preoperative and postoperative day 90 time points in the B+MMCR group (p < 0.001). Analysis of ocular surface scores revealed no difference in fluorescein staining between the control group and the B+MMCR group at any time points. There were no significant within or between-group differences in Schirmer, TBUT, or rose bengal scores at any time point.
In our study, we concluded that Muller’s muscle-conjunctival resection does not worsen dry eye symptoms or ocular surface parameters, therefore this technique may be considered safe even in patients with mild preoperative ocular surface disorders.
Link: https://doi.org/10.1080/01676830.2016.1243134
Bruna Rymer
CRM 31072
