Lower Eyelid Position Changes Following Müller’s Muscle-Conjunctival Resection Blepharoptosis Surgery
Author: Hossein Ghahvehchian
Base Hospital / Institution: Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Science, Tehran, Iran.
ePoster presentation
Abstract ID: 24-252
Purpose
Asymmetry of the lower eyelids and a lower position of the lower eyelid on the ptotic side are common issues observed in patients with upper lid ptosis. While these conditions have been previously discussed in the literature, the impact of ptosis correction on the lower eyelid requires further investigation. Understanding the relationship between upper lid ptosis correction and lower eyelid position will facilitate better treatment strategies. This study aimed to assess the lower eyelid position before and after Müller’s muscle-conjunctival resection (MMCR) in unilateral myogenic ptosis (MP) and aponeurotic ptosis (AP). Additionally, the study aimed to analyze the factors associated with these changes and evaluate the postoperative lower eyelid symmetry in both groups.
Methods
This prospective interventional before-and-after study, conducted from April 2021 to October 2022, included adult patients with blepharoptosis. Measurements of margin reflex distance (MRD) 1 and 2, levator function, and the amount of resection were taken before and 6 months after the surgery.
Results
A total of 47 patients included, with 29 having MP and 18 having AP. The mean ages were 31.55 ± 5.30 years and 50.11 ± 6.45 years, respectively. In MP group, there was a significant association between baseline MRD2 and the severity of ptosis (MRD1) (β= -0.739, p=0.004, multivariate regression analysis). After MMCR, significant decreases were observed in MRD2 for both MP (-0.38 ± 0.48 mm, p<0.001) and AP (-0.39 ± 0.47 mm, p=0.003). The symmetry of MRD2 remained stable at 41.4% in the MP group, while it decreased from 44.4% to 16.7% in the AP group. Multivariate regression analysis demonstrated that baseline MRD2 was the only significant factor associated with postoperative MRD2 in the MP group.
Conclusion
Patients with myogenic and aponeurotic ptosis often exhibit a lower position of the lower eyelid, which typically elevates after posterior upper lid ptosis surgery. In myogenic cases, the severity of preoperative lower eyelid position correlates with the severity of upper lid ptosis and predicts postoperative elevation of the lower lid.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Seyed Mohsen | Rafizade | Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Science, Tehran, Iran. |
