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Ju-Wen Yang
Background: The traditional technique for levator muscle resection includes a time-consuming dissection procedure that causes tissue trauma and swelling. The Putterman ptosis clamp has been popularly used in recent years for conjunctival müllerectomy. In this paper, we describe a modified surgical technique for ptosis treatment using the Putterman ptosis clamp. The modified technique improves the surgical results of levator muscle resection. Objectives: We performed a retrospective case-series study to determine the outcomes and complications associated with the use of the Putterman ptosis clamp in levator muscle resection...
November 28, 2017: Aesthetic Surgery Journal
Allen M Putterman
No abstract text is available yet for this article.
May 2016: Ophthalmic Plastic and Reconstructive Surgery
Preethi S Ganapathy, Rao V Chundury, Julian D Perry
PURPOSE: To evaluate the safety and effectiveness of a frontalis muscle transposition flap for treatment of lateral eyebrow ptosis. METHODS: The charts of all patients undergoing frontalis muscle transposition flap eyebrow ptosis repair from December 2013 to September 2014 were reviewed. Charts with inadequate photographs were excluded. Charts were reviewed for demographics, preoperative and postoperative photographs, surgical technique, and complications. The following parameters were assessed on preoperative and postoperative photographs: corneal diameter, central brow height, and lateral brow height...
November 2016: Ophthalmic Plastic and Reconstructive Surgery
Maria M Choudhary, Rao Chundury, Stephen A McNutt, Julian D Perry
PURPOSE: To quantitatively determine how accurately conjunctival Müllerectomy with or without tarsectomy (CM ± T) blepharoptosis repair restores eyelid contour. METHODS: The charts of all patients undergoing unilateral CM ± T blepharoptosis repair at the Cole Eye Institute between June 2012 and September 2014 were reviewed. Preoperative and postoperative digital images were used for eyelid contour analysis. Eyelid contour was measured according to a previously described technique measuring 13 radial mid-pupil eyelid distances (MPLDs) in pixels at 15° intervals from 0° to 180°...
September 2016: Ophthalmic Plastic and Reconstructive Surgery
Sonia Szamocki, Sabrina Shah-Desai
PURPOSE: To report the results of skin crease preservation with a modified technique of open-sky Muller's muscle-conjunctival resection that precludes the need to reconstruct the upper eyelid skin crease with full thickness sutures. METHODS: A nonrandomized, retrospective audit of 45 eyelids of 37 consecutive patients with acquired blepharoptosis, undergoing surgical correction by a single surgeon, between November 2011 and July 2014. Surgical technique involved subtotal resection of Muller's muscle plus underlying conjunctiva, under direct visualization...
September 2015: Ophthalmic Plastic and Reconstructive Surgery
Arie Y Nemet
BACKGROUND: The Hering's law effect has significant importance in surgical planning and outcomes of eyelid surgery. OBJECTIVES: The current study examined the preoperative and intraoperative effect of Hering's law in Mullerectomy and levator aponeurosis advancement. METHODS: A retrospective analysis was conducted of 52 patients with unilateral ptosis who underwent surgical repair from January 2011 through June 2013. Patients underwent levator aponeurosis advancement or Mullerectomy with or without tarsectomy...
September 2015: Aesthetic Surgery Journal
Jang Woo Park, Moon Seok Kang, Seung Min Nam, Yong Bae Kim
BACKGROUND: Many surgical techniques have been developed to correct blepharoptosis, including the anterior levator resection or advancement, tarsoaponeurectomy, and Fasanella-Servat Müllerectomy. However, to minimize surgical scarring and reduce the postoperative recovery time, the procedure has been developed from a complete incision to a partial incision, which is appealing to patients. To aid the procedural development, this study describes a surgical technique in which the correction of blepharoptosis and a double eyelid fold operation are performed using a buried suture technique during the same operation...
February 2015: Annals of Plastic Surgery
John D Pemberton, Peter W MacIntosh, Ahmaida Zeglam, Aaron Fay
Diagnosing Horner Syndrome can be difficult in the setting of an incomplete triad. A 27-year-old man presented with unilateral eyelid droop and intermittent ipsilateral headaches, having already seen 7 physicians. Physical examination revealed unilateral ptosis but no pupillary miosis or facial anhidrosis. Inspection of his clinical photographs revealed elevation of the ipsilateral lower eyelid, suggesting sympathetic dysfunction. On further questioning, he admitted to naphazoline dependence. Reexamination after ceasing the naphazoline unveiled the anisocoria...
March 2015: Ophthalmic Plastic and Reconstructive Surgery
Sara Filipa Teixeira Ribeiro, Denny M Garcia, Vítor Leal, Fernando Faria-Correia, Amândio Rocha-Sousa, Fernando Falcão-Reis, Antonio Augusto Velasco e Cruz
PURPOSE: To measure the effect of müllerectomy from posterior approach on the amplitudes of spontaneous blinking and downward eyelid saccades. METHODS: Spontaneous blinks and downward upper eyelid saccadic movements of 16 patients (23 eyelids) with Graves orbitopathy were measured before and after müllerectomy from posterior approach. A new video system was used to continuously register the blinking activity while subjects viewed a commercial movie for 5 minutes...
September 2014: Ophthalmic Plastic and Reconstructive Surgery
Sun Young Jang, Susie Chin, Jae Woo Jang
BACKGROUND: The purpose of this study was to report 10 years of experience with unilateral conjunctival mullerectomy in the Asian eyelid. METHODS: Medical records of patients with unilateral ptosis who underwent conjunctival mullerectomy performed by a single surgeon from January of 2001 to December of 2011 were reviewed. The following factors were investigated: preoperative marginal reflex distance-1 of the ptotic and contralateral normal eyelids, levator function, and preoperative marginal reflex distance-1 after instillation of 2...
April 2014: Plastic and Reconstructive Surgery
Alan Lowinger, Harmeet S Gill, Isabella Phan, Richard Garcia-Kennedy, Rona Z Silkiss
OBJECTIVE: Histologic examination of Müller's muscle (MM) in patients with clinically significant upper eyelid retraction secondary to Graves' orbitopathy (GO). DESIGN: Prospective, single-blinded, comparative experimental study at a single institution. PARTICIPANTS: Patients from a single San Francisco Bay Area practice (RZS). METHODS: Consecutive patients with upper eyelid retraction secondary to GO who underwent surgical correction by transcutaneous mullerectomy were recruited between January and December 2011...
December 2013: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Viraj J Mehta, Julian D Perry
PURPOSE: To compare outcomes of conjunctival Müllerectomy with or without tarsectomy versus external levator advancement for correction of upper blepharoptosis when performed by trainee versus staff surgeons. DESIGN: Retrospective, nonrandomized, interventional, consecutive case series. METHODS: Charts of patients undergoing conjunctival Müllerectomy with or without tarsectomy and external levator advancement blepharoptosis repair from January 2006 through December 2009 were reviewed...
February 2013: American Journal of Ophthalmology
Carrie L Morris, William R Morris, James C Fleming
BACKGROUND: The goals of this study were to determine whether the surgical target amount of Müller's muscle removed is consistent with the histological amount obtained, to assess the clinical outcome of ptosis repair based on these amounts, and to evaluate the role of the levator aponeurosis in the procedure. METHODS: The Müllerectomy procedure was performed on eight eyelids of four cadavers and eight eyelids of seven patients (six unilateral, one bilateral). Histologically, the dimensions of the Müller and levator muscles were measured in the specimens removed...
June 2011: Plastic and Reconstructive Surgery
Rajat Maheshwari, Sejal Maheshwari
PURPOSE: Results of Muller's muscle resection in patients with ptosis and its relationship with levator and Muller's muscle function. METHODS: Prospective review of medical records of all pateints who underwent open sky Mullerectomy for correction of upper eyelid ptosis. The study period was from January 2008 to July 2009. Levator function, MRD1, Phenylepherine test result and extent of ptosis correction were recorded. Excised muscle tissue in few cases were subjected to histopathology...
June 2011: Orbit
Felicia D Allard, Vikram D Durairaj
Ptosis refers to vertical narrowing of the palpebral fissure secondary to drooping of the upper eyelid to a lower than normal position. Ptosis is considered congenital if present at birth or if it is diagnosed within the first year of life. Correction of congenital ptosis is one of the most difficult challenges ophthalmologists face. Multiple surgical procedures are available including, frontalis sling, levator advancement, Whitnall sling, frontalis muscle flap, and Mullerectomy. Selection of one technique over another depends on the consideration of several factors including the surgeon experience, the degree of ptosis in the patient, as well as the degree of levator muscle function...
April 2010: Middle East African Journal of Ophthalmology
David F Jones, Cari E Lyle, James C Fleming
PURPOSE: Many anophthlamic patients with ocular prostheses experience chronic discharge. A subset of these patients is found to have concurrent ptosis and an enlarged superior conjunctival fornix. Examination reveals an enlarged superior fornix with copious mucopurulent discharge. The subset of patients meeting these criteria is very small, and estimated incidence cannot be determined. The authors propose that using a modification of the conjunctivomullerectomy to decrease the potential space in the enlarged fornix while at the same time correcting the ptosis will help alleviate this chronic discharge...
May 2010: Ophthalmic Plastic and Reconstructive Surgery
Daniel P Schaefer
PURPOSE: Many surgical techniques have been developed to address eyelid retraction with varying results. Identifying and evaluating the anatomical and pathophysiological factors involved will assist in its surgical treatment. This prospective study evaluated the graded levator hinge procedure, in combination with a Müllerectomy and/or lateral canthoplasty when indicated, in an attempt to precisely and selectively target the pathophysiology responsible for the various causes of eyelid retraction in only one surgical session...
2007: Transactions of the American Ophthalmological Society
Adam S Hassan, Bartley R Frueh, Victor M Elner
BACKGROUND: Facial nerve palsy often results in symptoms of ocular irritation due to inadequate eyelid closure. Weakened protractor function results in relative upper eyelid retraction and contributes to lagophthalmos. OBJECTIVE: To evaluate the role of müllerectomy in the comprehensive surgical treatment of ocular exposure due to facial nerve palsy. METHODS: Thirty-four patients with chronic facial nerve palsy underwent unilateral transconjunctival removal of Müller muscle and were followed up for an average of 20 months postoperatively...
September 2005: Archives of Ophthalmology
Julian D Perry, Anish Kadakia, Jill A Foster
PURPOSE: To determine the predictability of a new algorithm for determining the amount of tissue resection for conjunctival Müllerectomy with or without tarsectomy blepharoptosis repair. METHODS: Consecutive case series of all patients undergoing conjunctival Müllerectomy with or without tarsectomy ptosis repair from October 1999 to September 2001. Each patient underwent excision according to a new algorithm for determining the amount of tissue excision. The amount resected was determined by the following formula: 9 mm of conjunctiva and Müller muscle + x mm of tarsus, where x = distance of undercorrection after phenylephrine testing...
November 2002: Ophthalmic Plastic and Reconstructive Surgery
J-L George, M-E Tercero, K Angioï-Duprez, T Maalouf
INTRODUCTION: Mullerectomy by a conjunctival approach is an excellent way to reduce thyroid-related superior lid retraction. Especially the lateral horn of the levator, into the lacrimal gland, has to be reduced. Alterations in lacrimal secretion have been hypothesized, but never studied. MATERIALS AND METHODS: The basal and reflex Schirmer test and functional status were studied in 39 patients with thyroid-related orbitopathy after mullerectomy by a conjunctival approach (12 functional, 27 cosmetic indications)...
March 2002: Orbit
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