Transconjunctival Müller’s muscle Tucking Method for Non-incisional Correction of Mild Ptosis: The Effectiveness and Maintenance

Springer Science and Business Media LLC - Tập 43 - Trang 938-945 - 2019
Hyun Ho Han1, Min Soo Kim2
1Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
2Yonsei ENB Plastic Surgery Clinic, Seoul, Republic of Korea

Tóm tắt

In patients with a mild degree ptosis who undergo non-incisional double-eyelid blepharoplasty, simultaneous correction of ptosis is needed to prevent loosening. The transconjunctival Müller’s muscle tucking (TMMT) method may be useful in these cases. The authors performed this study to present the details of the current use of the TMMT method and to provide objective evidence for ptosis correction and its sustained effect. A total of 322 eyelids in 161 patients who underwent mild ptosis correction with the TMMT method from July 2012 to December 2017 were retrospectively examined. The continuous suture method using a single stitch was used for double-fold formation, and the TMMT method was used for ptosis correction for the other incision. The margin to reflex distance (MRD) 1 was evaluated at pre-operation, immediate post-operation, and at 2, 6 months post-operation. A total of 34 patients who had more than 6 months of follow-up were included. Right-side MRD1 values were 2.08 (± 0.19) mm before the surgery, 3.49 (± 0.16) mm immediately after the surgery, 3.33 (± 0.14) mm at postoperative 2 months, and 3.22 (± 0.17) mm at postoperative 6 months (p < 0.001). The difference of MRD1 between immediate post-operation and at 6 months was 0.25 mm without statistical significance (p > 0.05). Complications (fold loosening, asymmetry, and ptosis recurrence) occurred in three cases (8.8%), all of which were re-corrected by applying the TMMT method. The TMMT method was useful for correction of mild ptosis, showed little recurrence, and prevented loss of fold by giving a vertical force to the double-fold. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Tài liệu tham khảo

Baek S-M, Kim S-S, Tokunaga S, Bindiger A (1989) Oriental blepharoplasty: single-stitch, nonincision technique. Plast Reconstr Surg 83:236–242 Lee Y-J, Baek R-M, Chung W-J (2003) Nonincisional blepharoplasty using the debulking method. Aesthet Plast Surg 27:434–437 Moon K-C, Yoon E-S, Lee J-M (2013) Modified double-eyelid blepharoplasty using the single-knot continuous buried non-incisional technique. Arch Plast Surg 40:409 Mikamo M (1997) Mikamo’s double-eyelid operation: the advent of Japanese aesthetic surgery 1896. Plast Reconstr Surg 99:664 discussion-9 Jang SY, Chin S, Jang JW (2014) Ten years’ experience with unilateral conjunctival mullerectomy in the Asian eyelid. Plast Reconstr Surg 133:879–886 Putterman AM, Urist MJ (1975) Müller muscle-conjunctiva resection: technique for treatment of blepharoptosis. Arch Ophthalmol 93:619–623 Guyuron B, Davies B (1988) Experience with the modified Putterman procedure. Plast Reconstr Surg 82:775–780 Liu MT, Totonchi A, Katira K, Daggett J, Guyuron B (2012) Outcomes of mild to moderate upper eyelid ptosis correction using Müller’s muscle-conjunctival resection. Plast Reconstr Surg 130:799e–809e Simon GJB, Lee S, Schwarcz RM, McCann JD, Goldberg RA (2005) External levator advancement vs Müller’s muscle–conjunctival resection for correction of upper eyelid involutional ptosis. Am J Ophthalmol 140:426–432 Shimizu Y, Nagasao T, Asou T (2010) A new non-incisional correction method for blepharoptosis. J Plast Reconstr Aesthet Surg 63:2004–2012 Hu J-W, Byeon JH, Shim H-S (2015) Simultaneous double eyelid blepharoplasty and ptosis correction with a single-knot, continuous, nonincisional technique: a five-year review. Aesthet Surg J 36:14–20 Lee EJ, Hwang K (2013) Balanced plication of Müller muscle tendon through conjunctiva for blepharoptosis correction. J Craniofac Surg 24:599–601 Beard C (1966) The surgical treatment of blepharoptosis: a quantitative approach. Trans Am Ophthalmol Soc 64:401 Vagefi MR, Lin CC, McCann JD, Anderson RL (2008) Local anesthesia in oculoplastic surgery: precautions and pitfalls. Arch Facial Plast Surg 10:246–249 Marcet MM, Setabutr P, Lemke BN et al (2010) Surgical microanatomy of the Müller muscle-conjunctival resection ptosis procedure. Ophthal Plast Reconstr Surg 26:360–364 Maheshwari R, Maheshwari S (2011) Muller’s muscle resection for ptosis and relationship with levator and Muller’s muscle function. Orbit 30:150–153 Weinstein GS, Buerger JG (1982) Modification of the Müller’s muscle-conjunctival resection operation for blepharoptosis. Am J Ophthalmol 93:647–651 Dresner SC (1991) Further modifications of the Müller’s muscle-conjunctival resection procedure for blepharoptosis. Ophthal Plast Reconstr Surg 7:114–122 Jeong S, Lemke BN, Dortzbach RK, Park YG, Kang HK (1999) The Asian upper eyelid: an anatomical study with comparison to the Caucasian eyelid. Arch Ophthalmol 117:907–912 Choi Y, Kang HG, Nam YS (2017) Three skin zones in the Asian upper eyelid pertaining to the Asian blepharoplasty. J Craniofac Surg 28:892–897 Murchison AP, Sires BA, Jian-Amadi A (2009) Margin reflex distance in different ethnic groups. Arch Facial Plast Surg 11:303–305 Jutley G, Carpenter D, Hau S et al (2016) Upper and lower conjunctival fornix depth in healthy white caucasian eyes: a method of objective assessment. Eye 30:1351 Hwang K, Shin YH, Kim DJ (2008) Conjoint fascial sheath of the levator and superior rectus attached to the conjunctival fornix. J Craniofac Surg 19:241–245 Mizuno T (2016) Treatment of suture-related complications of buried-suture double-eyelid blepharoplasty in Asians. Plast Reconstr Surg Global Open 4(8):e839 Putterman A, Urist M (1978) Müller’s muscle-conjunctival resection ptosis procedure. Ophthalmic Surg 9:27–32