Abstract Listings 2024

Purpose

To evaluate de efficacy of mullerectomy to treat ptosis secondary to a hypercorrected mullerotomy in upper eyelid retraction in patients with thyroid eye disease.

Methods

We evaluated 9 patients with thyroid eye disease (TED) who had underwent bony orbital decompression and presented upper eyelid retraction and then secondary ptosis due to a hypercorrection of the retraction. The correction of the eyelid retraction was made through an anterior graded Müller disinsertion. Intraoperative eyelid height was assessed. However, ptosis was observed in the postoperative period. All patients responded positively to the fenilefrine test, so mullerectomy was performed to correct the ptosis.

Results

Nine patients were studied. Mean margin to reflex distance in the upper eyelid (MRD1) was 7,0+/-1.33 mm in the retracted eye after orbital decompression and before eyelid surgery. Early postoperative results were good in all patients. Secondary ptosis (DMR1 2,0 +/- 0,85 mm) was observed in an avarage time of 6,22 +/- 3,8 months. Good height and symmetry was obtained after mullerectomy in 6 patients (66.6% patients, mean DMR1 4,13 +/- 0,49 mm). 3 patients (33.3%) presented a hypercorrection (mean DMR1 5,9 +/- 0,17 mm) and were reoperated whitin 1-2 weeks. Good results were obtained after the reoperation in all three patients (DMR1 4,27 +/- 0,66 mm).

Conclusion

Mullerectomy is a useful tool to treat ptosis secondary to a hypercorrected mullerotomy in TED patients. However, the results are less predictable compared to naïve non-TED patients. Eyelid fibrosis implies a higher risk of hypercorrection.

Additional Authors

↑ Back to top