Predictability of conjunctival-Müellerectomy for blepharoptosis repair.

PURPOSE: To assess the predictability of the algorithm used to determine the amount of tissue resection for conjunctival-Müellerectomy during blepharoptosis repair. METHODS: A consecutive case series of all patients undergoing conjunctival-Müellerectomy during blepharoptosis repair between July 2001 and February 2005. All of the cases had a positive phenylephrine test, and the mean preoperative upper marginal reflex distance (MRD1) was +1.60 mm (range: -1 +/-3.5 mm). Each patient underwent excision according to the following algorithm: 10 mm of resection for 2 mm of ptosis, 8 mm of resection for 1.5 mm of ptosis, and 6 mm of resection for 1 mm of ptosis. RESULTS: Fifty-five patients underwent conjunctival-Müellerectomy during blepharoptosis repair on 73 eyelids, using the above algorithm. Thirty-seven cases were unilateral and 18 were bilateral. The mean postoperative MRD1 was +3.42 mm (range 0-+4.5 mm). Postoperative symmetry was found in 42 of 55 patients (76.4%) after one surgical procedure. Patient satisfaction based on contour, symmetry and height after one repair was achieved in 52 of 55 patients (94.55%). There were three reoperations for previous undercorrection. CONCLUSION: This algorithm quantifies conjunctival-Müellerectomy during blepharoptosis repair. Excellent and very predictable results are obtained by a technique that is both simple and achievable in a short operating time.

Comparison between motility of biointegratable and silicone orbital implants.

PURPOSE: To determine if there is a difference in motility between biointegratable orbital implants and silicone orbital implants in patients undergoing ocular evisceration. DESIGN: A retrospective comparative study. METHODS: We compared motility measuring the excursion of a mark on the conjunctiva at the center of the implant in eviscerated patients with silicone implants and biointegratable implants after same evisceration technique. RESULTS: Silicone implants had 0.5-mm increased movement in inferior and medial duction compared with biointegratable implants. The later had 0.1 mm of increased movement compared with silicone implants in lateral gaze. The greatest difference was in superior gaze, in which silicone implants had 1.5 mm more excursion than biointegratable implants. No significant difference was observed in horizontal and vertical movements between both groups. CONCLUSIONS: In our analysis, there does not seem to be any advantage, in terms of motility, in using biointegratable implants if "pegging" is not planned. Further studies are required.