경도 및 중등도 눈꺼풀처짐에서 결막뮐러근절제술과 눈꺼풀올림근널힘줄교정술 후 눈꺼풀윤곽 비교

Eyelid Contour Analysis Following Müller’s Muscle-conjunctival Resection and Levator Aponeurosis Advancement in Mild to Moderate Belpharoptosis

Purpose: To analyze both the effects and the eyelid contour of M&#252;ller’s muscle-conjunctival resection and levator aponeurosis advancement in patients with mild to moderate belpharoptosis. Methods: We conducted a retrospective cross-sectional study including 20 eyes of 16 patients who underwent M&#252;ller’s muscle-conjunctival resection and 25 eyes of 17 patients who underwent levator aponeurosis advancement from January 2012 to December 2015, where each patient was followed up for at least 6 months. Surgical success was defined as either a marginal reflex distance 1 (MRD 1 ) elevation greater than 2.5 mm postoperatively or a bilateral MRD 1 difference less than 0.5 mm. Both the conventional and 12 oblique mid-pupil lid distances were measured every 15 degrees using custom software developed in the MATLAB program (MathWorks, Natick, MA, USA). Results: The average correction of M&#252;ller’s muscle-conjunctival resection was 1.1 mm, while that of levator aponeurosis advancement was 0.9 mm. There was no significant difference in MRD 1 , MRD 2 , function of levator palpebrae muscle, or lid contour in the preoperative status between the M&#252;ller’s muscle-conjunctival resection group and the levator aponeurosis advancement group. The surgical success rate was 85% in the M&#252;ller’s muscle-conjunctival resection group and 84% in the levator aponeurosis advancement group, but this difference was not significant. The postoperative lid contour (superomedial side, 15°) was more effective in the M&#252;ller’s muscle-conjunctival resection group (p < 0.05). Conclusions: Overall, both types of blepharoptosis surgery were effective at correcting mild to moderate blepharoptosis. The correction of mild to moderate blepharoptosis using M&#252;ller’s muscle-conjunctival resection is an effective technique for elevating the eyelid and normalizing the eyelid contour. J Korean Ophthalmol Soc 2017;58(6):627-633