Abstract ID: 26-336
Sutureless Mullerectomy in the Aesthetic Oculoplastic Practice
Author: Rob van der Veen Base Hospital / Institution: Dr. Rob van der Veen – Oculoplastic Surgery
Presentation Type: ePoster Presentation
Purpose
The purpose of this study is to describe the applicability and advantage of a sutureless technique for correcting mild to moderate upper eyelid ptosis through Sutureless Müller Muscle Conjunctiva Resection (MMCR).
Methods
We describe a series of 49 eyes of 30 patients operated on by a single senior surgeon in private practices in Spain and the Netherlands. The principles of MMCR were followed in a standardised manner, using the 4:1 rule; 4 mm of resection for every 1 mm of desired correction. The difference between the classic technique and this approach is that, once the Putterman clamp is placed on the conjunctiva and Müller´s muscle, the tissue is excised directly without previous suture placement. We also do not place a haemostat clamp before excising. Hemostasis of the wound is then performed, and the tissues in the upper fornix are repositioned. We documented at baseline and at 8 weeks postoperatively: upper eyelid margin to corneal light reflex distance (MRD1 in mm), the palpebral fissure height (PF in mm), and standardised portret photographs.
Results
We performed the sutureless MMCR in a total of 49 eyes and achieved a mean increase in MRD1 of 1.14 mm (range 0 to 3 mm) and a mean increase in PF of 1.12 mm (range 0 to 4.5 mm). In two eyelids, no significant difference in MRD1 was observed after surgery. In addition, one other patient developed a pyogenic granuloma in one eyelid and exhibited a slight eyelid contour irregularity postoperatively.
Conclusion
Ptosis correction using a sutureless MMCR is an effective way of lifting the eyelid margin, it prevents potential corneal damage caused by suture placement, and shortens the surgical time. In our opinion it’s an ideal adjunct procedure for upper eyelid blepharoplasty.