Muller-muscle recession for mild to moderate upper-eyelid retraction
Objective: To describe a surgical procedure for the relief of mild to moderate upper-eyelid retraction secondary to Graves’ ophthalmopathy using a graded, controlled recession of Muller muscle without recession of the levator aponeurosis. Methods: Medical records of patients with mild to moderate...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Philippine Academy of Ophthalmology
2005-03-01
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| Series: | Philippine Journal of Ophthalmology |
| Subjects: | |
| Online Access: | https://paojournal.com/index.php/pjo/article/view/425 |
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| Summary: | Objective: To describe a surgical procedure for the relief of mild to moderate upper-eyelid retraction secondary to Graves’ ophthalmopathy using a graded, controlled recession of Muller muscle without recession of the levator aponeurosis.
Methods: Medical records of patients with mild to moderate upper-eyelid retraction secondary to Graves’ ophthalmopathy who underwent Muller-muscle recession were reviewed. Five female patients 40 to 48 years of age were included. All were biochemically and clinically euthyroid for at least 6 months before the surgery. Patients had neither fibrosis nor exophthalmos. The outcome was evaluated 2 weeks after the operation by measuring the eyelid aperture and corneal light reflex to upper-lid-margin distance (MRD1) in the primary position. Patients were assessed to have upper-eyelid retraction when the MRD1 is > 4. Corneal staining was assessed. Pre- and postoperative photographs were compared. The outcome was classified as good, acceptable, or unacceptable. The result was deemed stable if measurements remained unchanged during follow-up.
Results: Seven upper eyelids (of 5 patients) were corrected using Muller-muscle recession only. The procedure yielded good results in 2 cases of bilateral upper-eyelid retraction (MRD1 4.5 to 8 mm). For three patients who had unilateral upper-eyelid retraction (MRD1 4 to 8 mm), the results were good in 2 cases and acceptable in 1.
Conclusion: Muller-muscle recession is an effective means of relieving mild to moderate upper-eyelid retraction in patients with Graves’ ophthalmopathy before fibrosis sets in. |
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| ISSN: | 0031-7659 |