Maheshwari Rajat, Maheshwari Sejal
Netraseva Eye Associates, Jalna (Maharashtra), India.
Orbit. 2011 Jun;30(3):150-3. doi: 10.3109/01676831003666447.
Results of Muller's muscle resection in patients with ptosis and its relationship with levator and Muller's muscle function.
Prospective review of medical records of all pateints who underwent open sky Mullerectomy for correction of upper eyelid ptosis. The study period was from January 2008 to July 2009. Levator function, MRD1, Phenylepherine test result and extent of ptosis correction were recorded. Excised muscle tissue in few cases were subjected to histopathology.
In 11 patients who underwent 13 mullerectomy procedures for correction of upper eyelid ptosis, MRD1 increased an average by 2.54 mm. The amount of ptosis correction was 4.28 mm in pateints with either good levator function and/or Muller's action and 1mm in patients where both responses to phenylepherine and levator functions were poor. Histopathology revealed both straited and smooth muscle tissue in the excised specimens in all cases.
Mullerectomy porbably involves plication of the posterior layer of the levator aponeurosis. Results of Muller's muscle resection is good in patients with good levator function and/or good Mullers action and poor if both Muller and levator function are poor.
探讨上睑下垂患者米勒肌切除术的效果及其与提上睑肌和米勒肌功能的关系。
对所有接受开放式米勒肌切除术矫正上睑下垂患者的病历进行前瞻性回顾。研究时间为2008年1月至2009年7月。记录提上睑肌功能、MRD1、去氧肾上腺素试验结果及上睑下垂矫正程度。少数病例切除的肌肉组织进行组织病理学检查。
11例患者接受了13次米勒肌切除术矫正上睑下垂,MRD1平均增加2.54mm。提上睑肌功能良好和/或米勒肌功能良好的患者上睑下垂矫正量为4.28mm,而去氧肾上腺素反应和提上睑肌功能均较差的患者上睑下垂矫正量为1mm。组织病理学检查显示,所有病例切除标本中均有横纹肌和平滑肌组织。
米勒肌切除术可能涉及提上睑肌腱膜后层的折叠。提上睑肌功能良好和/或米勒肌功能良好的患者米勒肌切除术效果良好,而米勒肌和提上睑肌功能均较差的患者效果较差。