The role of Muller’s muscle in the occurrence and surgical treatment of the upper eyelid ptosis

Dzagurova, Z. R.

doi:10.17116/oftalma2020136041151

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Firstly, what is the relationship between the correction of severe ptosis and conjunctival prolapse with CFS+LM suspension procedure? The study discovered that regardless of the chosen surgical intervention to correct ptosis, it aims to shorten and modify the tissue structure above the conjunctiva, without altering the length of the conjunctival itself.The normal width of the tarsal plate is 8~9mm, whereas the length of the Whitnall ligament from the upper edge of the tarsal plate is approximately 20~22mm [ 20 , 21 ]. In patients with mild blepharoptosis, only the levator muscle is correctly advanced, folded or shortened, and the fornix conjunctiva overlaps only minimally, typically not extending beyond the upper eyelid margin.…”

Section: Resultsmentioning

confidence: 99%

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

Xi,

He,

Yang

2024

BMC Ophthalmol

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Background In Asian patients with severe ptosis,the use of conjoint fascia sheath (CFS) suspension or levator aponeurosis fascia complex shortening surgery can correct the ptosis. During these surgery, a significant amount of levator aponeurosis fascia shortening is performed, which often leads to serious complications such as conjunctival prolapse.This study compares two surgical approaches for correcting severe blepharoptosis:Conjoint fascial sheath (CFS) + levator aponeurosis and muller’s muscle complex (LM complex) suspension and conjoint fascial sheath (CFS) + LM complex+conjunctival suspension.The postoperative efficacy and the incidence of complications such as conjunctival prolapse are investigated for both procedures. Methods This study retrospectively analyzed 70 patients (77eyes) with severe blepharoptosis from January 2019 to December 2021. The patients were divided into the experimental group (34 cases, 38 eyes) and the control group (36 cases, 39 eyes). The experimental group was treated with CFS+LM complex + conjunctival suspension, and the control group was treated with CFS+LM complex suspension.The curative effect of blepharoptosis, the incidence of complications such as conjunctival prolapse and patient satisfaction were compared between the two different surgical methods. Results There was no significant difference in the correction effective rate between the experimental group (84.21%) and the control group (82.05%) (P > 0.05). There was no significant difference in the total incidence of complications between the experimental group (23.68%) and the control group (38.46%) (P > 0.05), but in the complication of conjunctival prolapse, the incidence of conjunctival prolapse in the experimental group was significantly lower than that in the control group. The difference was statistically significant (P < 0.05). In the survey of patient satisfaction rate, the satisfaction rate of the experimental group was significantly higher than that of the control group,which was statistically significant (P < 0.05). Conclusions Compared to CFS+LM complex suspension surgery, the CFS+LM complex + conjunctival suspension has a definite effect in preventing postoperative conjunctival prolapse .The procedure has a high feasibility, good corrective effect, and improves patient satisfaction after surgery.

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Section: Resultsmentioning

confidence: 99%

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

Xi,

He,

Yang

2024

BMC Ophthalmol

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“…In the summary of the daily surgical methods, we found a modified method of the levator palpebrae superioris advancement, that is, the levator palpebrae superioris high advancement, after full exposure of the elevation of the levator palpebrae superioris aponeurotic membrane, observing and judging the development of the levator palpebrae superioris, presutured during the operation, and instructed the patient to open his eyes and close his eyes during the operation to observe the effect and adjust it, so as to choose a most suitable position, cut off the levator palpebrae superioris aponeurotic membrane—Miller muscle below this position,14–16and partially detach from the forehead. Stretch the end down and suture on the tarsal plate 1/3, so that the levator palpebrae superioris aponeurotic membrane and Miller muscle to form a stable composite structure 17.…”

Section: Discussionmentioning

confidence: 99%

One Patient of Blepharoptosis Caused by Levator Palpebrae Superioris Aponeurosis Degeneration

Tang

Wang

et al. 2022

Journal of Craniofacial Surgery

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Ptosis is one of the common diseases of plastic surgery, which is caused by various causes of levator palpebrae superioris dysfunction or Müller muscle insufficiency, which is manifested by the upper eyelid margin being lower than normal when level viewed. Ptosis can be divided into congenital and acquired, and the main cause of congenital ptosis is due to congenital levator palpebrae superioris dysplasia or the motor nerve innervation that innervates it is caused by abnormal oculomotor neurodevelopment and dysfunction. Acquired ptosis can be divided into traumatic, neurogenic, myogenic, senile, mechanical, and false ptosis. At present, there are few reports of ptosis due to the degeneration of the aponeurosis of the upper eyelid muscle. We received a case of ptosis caused by degeneration of the levator palpebrae superioris aponeurotic mem-brane, we use the method of the levator palpebrae superioris high advancement. The levator palpebrae superioris-Miller muscle was folded to form a stable composite structure by the levator palpebrae superioris high advancement. During the operation, the levator palpebrae superioris was separated along the gap, and the surrounding tissues were less damaged. Therefore, postoperative adhesion was less, and the main complications of severe blepharoptosis after the operation, such as upper eyelid hysteresis and incomplete closure, almost did not occur, and after surgery, the results were good.

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“…According to Bookman, resection of the tarsal plate should be minimal due to the fact that the tarsal plate is the main frame of the upper eyelid and its resection leads to deformity of the upper eyelid. Recently, many researchers have begun to promote the technique with resection of the superior tarsal muscle (Muller muscle) without resection or with partial resection of the tarsal plate (Dzagurova, 2020;Congenital ptosis repair, 2013;Müller's muscle-conjunctival resection, 2012). According to these authors, one of the causes of acquired ptosis of the upper eyelid is fatty degeneration of the superior tarsal muscle, which leads to a decrease in its contractility.…”

Section: Purpose Of the Studymentioning

confidence: 99%

Review of recent advances in the ptosis treatment of the upper eyelid

Akhmedov¹

2023

ijhms

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The article provides a literary review of the methods of surgical correction of blepharoptosis. The methods are divided into the following groups: upper blepharoplasty, operations with hanging the upper eyelid to the frontalis muscle, operations with various methods of shortening the eyelid levator muscle, operations with attachment of the levator of the eyelid to the upper rectus muscle of the eye, Muller’s muscle resection technique. The advantages and disadvantages of these methods are indicated.

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The role of Muller’s muscle in the occurrence and surgical treatment of the upper eyelid ptosis

Cited by 4 publications

References 26 publications

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

One Patient of Blepharoptosis Caused by Levator Palpebrae Superioris Aponeurosis Degeneration

Review of recent advances in the ptosis treatment of the upper eyelid

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