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Clinical effects of conjunctiva-Müller muscle resection in anophthalmic ptosis.

Ha SW, Lee JM, Jeung WJ, Ahn HB - Korean J Ophthalmol (2007)

Bottom Line: Mean follow-up period after the operation was 2 to 16 months (average: 8.1 months).Surgery was successful in most patients, and postoperative difference in MRD 1 was less than 1 mm from the sound eye.No special postoperative complication was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, College of Medicine, Pochun CHA University, Pundang CHA Hospital, Sungnam, Korea.

ABSTRACT

Purpose: To evaluate the clinical effects of conjunctiva-Muller muscle resection through conjunctival incision in anophthalmic patients with mild ptosis.

Methods: Conjunctiva-Müller muscle resection was performed by one surgeon in 8 patients (8 eyes) who had received evisceration or enucleation and responded to 10% phenylephrine solution to correct ptosis. The average age of the patients was 35.87+/-13.4 years. Ptosis was seen from 1 to 34 months after evisceration or enucleation. The preoperative MRD 1 was -2 to 0.5 mm (average: -0.25+/-1.10 mm) and the difference of MRD 1 between before and after 10% phenylephrine use was 2.56+/-0.98 mm. The Müller muscle was resected 7.5 to 9 mm through conjunctival incision during surgery to match the MRD 1 of sound eye. Mean follow-up period after the operation was 2 to 16 months (average: 8.1 months).

Results: Postoperatively, the MRD 1 increased by 1.81+/-0.88 mm on the average, corresponding to the improvement in lid elevation after the use of 10% phenylephrine performed before resection. Surgery was successful in most patients, and postoperative difference in MRD 1 was less than 1 mm from the sound eye. No special postoperative complication was observed.

Conclusions: Conjunctiva-Müller muscle resection is one of the effective methods of correcting mild ptosis in anophthalmic patients.

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Related in: MedlinePlus

Pathologic biopsy of surgical resection after conjunctivomüllerectomy using H & E staining (A) and immunohistochemistry staining of smooth muscle actin (B). (×200)
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Figure 1: Pathologic biopsy of surgical resection after conjunctivomüllerectomy using H & E staining (A) and immunohistochemistry staining of smooth muscle actin (B). (×200)

Mentions: After confirming that all patients responded to 10% phenylephrine, conjunctiva-Müller muscle resection was performed to improve lid elevation. Histopathologic examination was performed on tissue specimen obtained during surgery. H & E staining and immunohistochemical staining of smooth muscle actin were used to confirm the presence of Müller muscle, and it was observed in all samples (Fig. 1). The average follow-up period after surgery was 8.1 months. The MRD 1 showed significant improvement in all patients by postoperative 1 month (Fig. 2, 3). The average lid elevation over 1 month after surgery was 1.81±0.88 mm, showing less lid elevation compared with that seen before surgery in phenylephrine test. However, the difference in MRD 1 was less than 1mm compared with the normal eye in all patients except in one patient, suggesting successful surgical outcome (Table 3). Postoperative complication such as difficulty of inserting the false eye due to conjunctival sac shrinkage or dry eye was not seen.


Clinical effects of conjunctiva-Müller muscle resection in anophthalmic ptosis.

Ha SW, Lee JM, Jeung WJ, Ahn HB - Korean J Ophthalmol (2007)

Pathologic biopsy of surgical resection after conjunctivomüllerectomy using H & E staining (A) and immunohistochemistry staining of smooth muscle actin (B). (×200)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629698&req=5

Figure 1: Pathologic biopsy of surgical resection after conjunctivomüllerectomy using H & E staining (A) and immunohistochemistry staining of smooth muscle actin (B). (×200)
Mentions: After confirming that all patients responded to 10% phenylephrine, conjunctiva-Müller muscle resection was performed to improve lid elevation. Histopathologic examination was performed on tissue specimen obtained during surgery. H & E staining and immunohistochemical staining of smooth muscle actin were used to confirm the presence of Müller muscle, and it was observed in all samples (Fig. 1). The average follow-up period after surgery was 8.1 months. The MRD 1 showed significant improvement in all patients by postoperative 1 month (Fig. 2, 3). The average lid elevation over 1 month after surgery was 1.81±0.88 mm, showing less lid elevation compared with that seen before surgery in phenylephrine test. However, the difference in MRD 1 was less than 1mm compared with the normal eye in all patients except in one patient, suggesting successful surgical outcome (Table 3). Postoperative complication such as difficulty of inserting the false eye due to conjunctival sac shrinkage or dry eye was not seen.

Bottom Line: Mean follow-up period after the operation was 2 to 16 months (average: 8.1 months).Surgery was successful in most patients, and postoperative difference in MRD 1 was less than 1 mm from the sound eye.No special postoperative complication was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, College of Medicine, Pochun CHA University, Pundang CHA Hospital, Sungnam, Korea.

ABSTRACT

Purpose: To evaluate the clinical effects of conjunctiva-Muller muscle resection through conjunctival incision in anophthalmic patients with mild ptosis.

Methods: Conjunctiva-Müller muscle resection was performed by one surgeon in 8 patients (8 eyes) who had received evisceration or enucleation and responded to 10% phenylephrine solution to correct ptosis. The average age of the patients was 35.87+/-13.4 years. Ptosis was seen from 1 to 34 months after evisceration or enucleation. The preoperative MRD 1 was -2 to 0.5 mm (average: -0.25+/-1.10 mm) and the difference of MRD 1 between before and after 10% phenylephrine use was 2.56+/-0.98 mm. The Müller muscle was resected 7.5 to 9 mm through conjunctival incision during surgery to match the MRD 1 of sound eye. Mean follow-up period after the operation was 2 to 16 months (average: 8.1 months).

Results: Postoperatively, the MRD 1 increased by 1.81+/-0.88 mm on the average, corresponding to the improvement in lid elevation after the use of 10% phenylephrine performed before resection. Surgery was successful in most patients, and postoperative difference in MRD 1 was less than 1 mm from the sound eye. No special postoperative complication was observed.

Conclusions: Conjunctiva-Müller muscle resection is one of the effective methods of correcting mild ptosis in anophthalmic patients.

Show MeSH
Related in: MedlinePlus