Abstract ID: 26-267
Step by Step Posterior Approach Ptosis Surgery: Müller’s Muscle-Conjunctival Resection (MMCR)
Author: Elia Franzolin Base Hospital / Institution: University Hospital of Verona, Italy
Presentation Type: Video Presentation
Purpose
To demonstrate the surgical steps of a posterior Müller’s muscle-conjunctival resection (MMCR) for correcting aponeurotic blepharoptosis. The video highlights a standardized technique using an internalized continuous suture and a therapeutic contact lens, avoiding suture externalization.
Methods
To present a 76-year-old female with aponeurotic ptosis undergoing an 8 mm MMCR. The eyelid is everted over a Desmarres retractor using a 4-0 Prolene trans-tarsal traction suture. Markings are placed 4 mm above the superior tarsal border. The conjunctiva-Müller’s muscle complex is engaged with 5-0 silk sutures and isolated with a Putterman clamp. A 6-0 Vicryl continuous mattress suture is placed below the clamp. Following tissue excision along the clamp, the internalized suture is tied. A bandage contact lens is placed to protect the cornea.
Results
The video illustrates precise tissue engagement and the internalized suturing technique required for a successful MMCR. This approach provided excellent hemostasis and margin contour while maximizing patient comfort without cutaneous suture externalization. The patient achieved optimal eyelid height and symmetry without postoperative ocular surface irritation.
Conclusion
MMCR with an internalized suture and a bandage contact lens is a predictable, safe, and effective procedure for aponeurotic ptosis. This step-by-step video provides a clear educational resource for optimizing surgical workflow and achieving excellent functional and aesthetic outcomes while minimizing patient discomfort.