Sutureless Conjunctiva-Sparing Posterior Ptosis Repair Surgery: A Novel Technique

Ronald Mancini; Parsha Forouzan; Zachary G. Keenum; Phillip A. Tenzel; W. Matthew Petroll

doi:10.1016/j.ajo.2023.03.001

Sutureless Conjunctiva-Sparing Posterior Ptosis Repair Surgery: A Novel Technique

Ronald Mancini, Parsha Forouzan, Zachary G. Keenum, Phillip A. Tenzel, W. Matthew Petroll

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

PURPOSE: Müller muscle-conjunctival resection (MMCR) is a popular posterior/internal surgical approach to cases of mild to moderate blepharoptosis with good levator function. MMCR necessitates the removal of healthy conjunctiva and exposes the cornea to suture material. The goal of this study is to describe a novel sutureless conjunctiva-sparing Müllerectomy (CSM) surgery and demonstrate its long-term efficacy, efficiency, and safety. DESIGN: IRB approved retrospective study of patients undergoing sutureless conjunctiva-sparing posterior ptosis repair surgery. METHODS: The medical records of 100 patients (171 eyes) who underwent sutureless CSM with a minimum follow-up interval of 6 months were retrospectively reviewed. Photographs were analyzed using ImageJ software. Outcome measures were derived from margin reflex distance 1 (MRD1) and palpebral fissure height (PFH) at various postoperative timepoints. RESULTS: Mean ΔMRD1 and ΔPFH at 6 months were 2.85 ± 0.98 mm and 2.60 ± 1.38 mm, respectively. Symmetry within 1 mm was observed 91% of cases. Sutureless CSM took 4.42 minutes on average compared to 8.45 minutes for traditional MMCR. There were no corneal abrasions or ocular complications. The reoperation rate was 2.3% (1 case of overcorrection and 3 cases of undercorrection) per eye. CONCLUSIONS: Sutureless CSM is a promising alternative to traditional MMCR and sutured CSM based on long-term outcomes, symmetry, shorter operative time, and low complication rate.

Original language	English (US)
Pages (from-to)	77-89
Number of pages	13
Journal	American journal of ophthalmology
Volume	251
DOIs	https://doi.org/10.1016/j.ajo.2023.03.001
State	Published - Jul 2023

ASJC Scopus subject areas

Ophthalmology

Access to Document

10.1016/j.ajo.2023.03.001

Cite this

@article{4e283817e8a6478894578de62d0dd0cf,

title = "Sutureless Conjunctiva-Sparing Posterior Ptosis Repair Surgery: A Novel Technique",

abstract = "PURPOSE: M{\"u}ller muscle-conjunctival resection (MMCR) is a popular posterior/internal surgical approach to cases of mild to moderate blepharoptosis with good levator function. MMCR necessitates the removal of healthy conjunctiva and exposes the cornea to suture material. The goal of this study is to describe a novel sutureless conjunctiva-sparing M{\"u}llerectomy (CSM) surgery and demonstrate its long-term efficacy, efficiency, and safety. DESIGN: IRB approved retrospective study of patients undergoing sutureless conjunctiva-sparing posterior ptosis repair surgery. METHODS: The medical records of 100 patients (171 eyes) who underwent sutureless CSM with a minimum follow-up interval of 6 months were retrospectively reviewed. Photographs were analyzed using ImageJ software. Outcome measures were derived from margin reflex distance 1 (MRD1) and palpebral fissure height (PFH) at various postoperative timepoints. RESULTS: Mean ΔMRD1 and ΔPFH at 6 months were 2.85 ± 0.98 mm and 2.60 ± 1.38 mm, respectively. Symmetry within 1 mm was observed 91% of cases. Sutureless CSM took 4.42 minutes on average compared to 8.45 minutes for traditional MMCR. There were no corneal abrasions or ocular complications. The reoperation rate was 2.3% (1 case of overcorrection and 3 cases of undercorrection) per eye. CONCLUSIONS: Sutureless CSM is a promising alternative to traditional MMCR and sutured CSM based on long-term outcomes, symmetry, shorter operative time, and low complication rate.",

author = "Ronald Mancini and Parsha Forouzan and Keenum, {Zachary G.} and Tenzel, {Phillip A.} and Petroll, {W. Matthew}",

note = "Funding Information: Funding/Support: This study received no funding. Financial Disclosures: None of the authors report financial disclosures or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship. Acknowledgments: The authors thank Soheila Talaeizadeh for beautifully illustrating their surgical technique. Author contributions are as follows: design and conduct of the study (R.M. P.F.); collection, management, analysis, and interpretation of data (R.M. P.F. M.P.); preparation, review, and approval of manuscript (R.M. P.F. P.T. Z.K. M.P.); development of surgical procedure and instrumentation (R.M. Z.K. P.T.). Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = jul,

doi = "10.1016/j.ajo.2023.03.001",

language = "English (US)",

volume = "251",

pages = "77--89",

journal = "American journal of ophthalmology",

issn = "0002-9394",

publisher = "Elsevier USA",

}

TY - JOUR

T1 - Sutureless Conjunctiva-Sparing Posterior Ptosis Repair Surgery

T2 - A Novel Technique

AU - Mancini, Ronald

AU - Forouzan, Parsha

AU - Keenum, Zachary G.

AU - Tenzel, Phillip A.

AU - Petroll, W. Matthew

N1 - Funding Information: Funding/Support: This study received no funding. Financial Disclosures: None of the authors report financial disclosures or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship. Acknowledgments: The authors thank Soheila Talaeizadeh for beautifully illustrating their surgical technique. Author contributions are as follows: design and conduct of the study (R.M. P.F.); collection, management, analysis, and interpretation of data (R.M. P.F. M.P.); preparation, review, and approval of manuscript (R.M. P.F. P.T. Z.K. M.P.); development of surgical procedure and instrumentation (R.M. Z.K. P.T.). Publisher Copyright: © 2023 Elsevier Inc.

PY - 2023/7

Y1 - 2023/7

N2 - PURPOSE: Müller muscle-conjunctival resection (MMCR) is a popular posterior/internal surgical approach to cases of mild to moderate blepharoptosis with good levator function. MMCR necessitates the removal of healthy conjunctiva and exposes the cornea to suture material. The goal of this study is to describe a novel sutureless conjunctiva-sparing Müllerectomy (CSM) surgery and demonstrate its long-term efficacy, efficiency, and safety. DESIGN: IRB approved retrospective study of patients undergoing sutureless conjunctiva-sparing posterior ptosis repair surgery. METHODS: The medical records of 100 patients (171 eyes) who underwent sutureless CSM with a minimum follow-up interval of 6 months were retrospectively reviewed. Photographs were analyzed using ImageJ software. Outcome measures were derived from margin reflex distance 1 (MRD1) and palpebral fissure height (PFH) at various postoperative timepoints. RESULTS: Mean ΔMRD1 and ΔPFH at 6 months were 2.85 ± 0.98 mm and 2.60 ± 1.38 mm, respectively. Symmetry within 1 mm was observed 91% of cases. Sutureless CSM took 4.42 minutes on average compared to 8.45 minutes for traditional MMCR. There were no corneal abrasions or ocular complications. The reoperation rate was 2.3% (1 case of overcorrection and 3 cases of undercorrection) per eye. CONCLUSIONS: Sutureless CSM is a promising alternative to traditional MMCR and sutured CSM based on long-term outcomes, symmetry, shorter operative time, and low complication rate.

AB - PURPOSE: Müller muscle-conjunctival resection (MMCR) is a popular posterior/internal surgical approach to cases of mild to moderate blepharoptosis with good levator function. MMCR necessitates the removal of healthy conjunctiva and exposes the cornea to suture material. The goal of this study is to describe a novel sutureless conjunctiva-sparing Müllerectomy (CSM) surgery and demonstrate its long-term efficacy, efficiency, and safety. DESIGN: IRB approved retrospective study of patients undergoing sutureless conjunctiva-sparing posterior ptosis repair surgery. METHODS: The medical records of 100 patients (171 eyes) who underwent sutureless CSM with a minimum follow-up interval of 6 months were retrospectively reviewed. Photographs were analyzed using ImageJ software. Outcome measures were derived from margin reflex distance 1 (MRD1) and palpebral fissure height (PFH) at various postoperative timepoints. RESULTS: Mean ΔMRD1 and ΔPFH at 6 months were 2.85 ± 0.98 mm and 2.60 ± 1.38 mm, respectively. Symmetry within 1 mm was observed 91% of cases. Sutureless CSM took 4.42 minutes on average compared to 8.45 minutes for traditional MMCR. There were no corneal abrasions or ocular complications. The reoperation rate was 2.3% (1 case of overcorrection and 3 cases of undercorrection) per eye. CONCLUSIONS: Sutureless CSM is a promising alternative to traditional MMCR and sutured CSM based on long-term outcomes, symmetry, shorter operative time, and low complication rate.

UR - http://www.scopus.com/inward/record.url?scp=85153510654&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85153510654&partnerID=8YFLogxK

U2 - 10.1016/j.ajo.2023.03.001

DO - 10.1016/j.ajo.2023.03.001

M3 - Article

C2 - 36898493

AN - SCOPUS:85153510654

SN - 0002-9394

VL - 251

SP - 77

EP - 89

JO - American journal of ophthalmology

JF - American journal of ophthalmology

ER -

Sutureless Conjunctiva-Sparing Posterior Ptosis Repair Surgery: A Novel Technique

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this