Email this article 
Post a Comment White line motility test in transconjunctival muellerectomy for blepharoptosis
- Authors: Potyomkin V.V.1,2, Goltsman E.V.2
-
Affiliations:
- Pavlov First Saint Petersburg State Medical University
- City Ophthalmologic Center of City hospital No. 2
- Issue: Vol 12, No 4 (2019)
- Pages: 87-91
- Section: In ophthalmology practitioners
- URL: https://journals.rcsi.science/ov/article/view/15811
- DOI: https://doi.org/10.17816/OV15811
- ID: 15811
Cite item
Abstract
Introduction. It is common knowledge that positive response to phenylephrine (PE) test remains the main indication for superior tarsal muscle (STM) resection for mild and moderate blepharoptosis. However, in recent times, there have been reports about possibility of STM resection in patients with weakly positive and negative responses to the PE test. However, the question remains open what a surgeon should focus on when planning STM resection in these cases? Authors have developed a test for assessing motility of the white line that could help to answer this question.
Materials and methods. 75 patients (103 eyelids) operated for blepharoptosis with STM resection in Saint Petersburg City Hospital No. 2 from November 2017 until august 2019 were enrolled in the study.
Results. We found no significant correlation between the result of white line motility test in patients with positive response to PE test and the effect of surgery, while in patients with week and negative PE test results there was a strong correlation.
Conclusion. The white line motility test could help to assess the desired amount of STM resection in patients with week and negative phenylephrine test results.
Full Text
##article.viewOnOriginalSite##About the authors
Vitaly V. Potyomkin
Pavlov First Saint Petersburg State Medical University; City Ophthalmologic Center of City hospital No. 2
Email: potem@inbox.ru
PhD, Assistant Professor, Department of Ophthalmology; Ophthalmologist
Russian Federation, Saint PetersburgElena V. Goltsman
City Ophthalmologic Center of City hospital No. 2
Author for correspondence.
Email: ageeva_elena@inbox.ru
ophthalmologist
Russian Federation, Saint PetersburgReferences
- Fasanella RM, Servat J. Levator resection for minimal ptosis: another simplified operation. Arch Ophthalmol. 1961;65(4):493-496. https://doi.org/10.1001/archopht.1961.01840020495005.
- Blaskovics L. A new operation for ptosis with shortening of the levator and tarsus. Arch Ophthalmol. 1923;52:563.
- Glatt HJ, Fett DR, Putterman AM. Comparison of 2.5 % and 10 % phenylephrine in the elevation of upper eyelids with ptosis. Ophthalmic Surg. 1990;21(3):173-176.
- Ben Simon GJ, Lee S, Schwarcz RM, et al. Müller’s Muscle-conjunctival resection for correction of upper eyelid ptosis: relationship between phenylephrine testing and the amount of tissue resected with final eyelid position. Arch Facial Plast Surg. 2007;9(6):413-417. https://doi.org/10.1001/archfaci.9.6.413.
- Baldwin HC, Bhagey J, Khooshabeh R. Open sky Muller muscle-conjunctival resection in phenylephrine test-negative blepharoptosis patients. Ophthalmic Plast Reconstr Surg. 2005;21(4): 276-280. https://doi.org/10.1097/01.iop.0000167789.39570.3e.
- Peter NM, Khooshabeh R. Open-sky isolated subtotal Muller’s muscle resection for ptosis surgery: a review of over 300 cases and assessment of long-term outcome. Eye (Lond). 2013;27(4):519-524. https://doi.org/10.1038/eye.2012.303.
- Manson PN, Lazarus RB, Morgan R, Iliff N. Pathways of sympathetic innervation to the superior and inferior (Müller’s) tarsal muscles. Plast Reconstr Surg. 1986;78(1):33-40. https://doi.org/10.1097/00006534-198607000-00004.
- Kuwabara T, Cogan DG, Johnson CC. Structure of the muscles of the upper eyelid. Arch Ophthalmol. 1975;93(11):1189-1197. https://doi.org/10.1001/archopht.1975.01010020889012.
- Esperidião-Antonio V, Conceição-Silva F, De-Ary-Pires B, et al. The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations Anat Sci Int. 2010;85(1):1-7. https://doi.org/10.1007/s12565-009-0043-0.
- Patel V, Salam A, Malhotra R. Posterior approach white line advancement ptosis repair: the evolving posterior approach to ptosis surgery. Br J Ophthalmol. 2010;94(11):1513-1518. https://doi.org/10.1136/bjo.2009.172353.
- Ichinose A, Leibovitch I. Transconjunctival levator aponeurosis advancement without resection of Müller’s muscle in aponeurotic ptosis repair. Open Ophthalmol J. 2010;4:85-90. https://doi.org/10.2174/1874364101004010085.
- Perry JD, Kadakia A, Foster JA. A new algorithm for ptosis repair using conjunctival Müllerectomy with or without tarsectomy. Ophthalmic Plast Reconstr Surg. 2002;18(6):426-429. https://doi.org/10.1097/00002341-200211000-00007.
- Lake S, Mohammad-Ali FH, Khooshabeh R. Open sky Müller’s muscle-conjunctiva resection for ptosis surgery. Eye (Lond). 2003;17(9):1008-1012. https://doi.org/10.1038/sj.eye. 6700623.
- Dresner SC. Further modifications of the Müller’s muscle-conjunctival resection procedure for blepharoptosis. Ophthalmic Plast Reconstr Surg. 1991;7(2):114-122. https://doi.org/10.1097/00002341-199106000-00005.
- Rootman DB, Karlin J, Moore G, Goldberg R. The role of tissue resection length in the determination of post-operative eyelid position for Muller’s muscle-conjunctival resection surgery. Orbit. 2015;34(2):92-98. https://doi.org/10.3109/01676830.2014. 999096.
Supplementary files
