Rootman Dan B, Karlin Justin, Moore Grant, Goldberg Robert
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California , Los Angeles, California , USA and.
Orbit. 2015 Apr;34(2):92-8. doi: 10.3109/01676830.2014.999096. Epub 2015 Mar 25.
To investigate the relationships between pre-operative marginal reflex distance (MRD), tissue resection length, phenylephrine response, and change in MRD with surgery for a cohort of individuals undergoing Muller's muscle conjunctival resection (MMCR) surgery.
All cases of MMCR surgery performed over a 13-year period at a single institution were screened for entry. Individuals with adequate photographic documentation and follow up were included. Patients with previous or concurrent upper eyelid, orbital or eyebrow disease of surgery were excluded. Marginal reflex distance (MRD) was calculated based on photographs utilizing public domain software. Data was plotted for inspection and appropriate statistical tests were performed.
During the study period 198 eyes fit criteria for analysis. A loose association between tissue resection length and change in MRD with surgery was found (r = 0.176, p < 0.05); this relationship was not significant in ANOVA analysis (p = 0.367). There was a strong association between MRD change with surgery and pre-operative MRD (r = 0.498, p < 0.01). Approximately 28% of the sample responded to 2.5% phenylephrine drop instillation with a greater than 2 mm increase in MRD. The response to phenylephrine was strongly associated with pre-operative MRD (r = -0.441, p < 0.01). A regression on change in MRD with surgery with tissue resection, phenylephrine response >2 mm and pre-operative MRD as variables revealed a model with pre-operative MRD as the only significant predictor (p < 0.01).
Tissue resection length and phenylephrine response play small roles relative to pre-operative MRD in the determination of change in MRD with MMCR surgery.
探讨一组接受米勒肌结膜切除术（MMCR）的个体术前边缘反射距离（MRD）、组织切除长度、去氧肾上腺素反应以及手术前后MRD变化之间的关系。
筛选出在单一机构进行的为期13年的所有MMCR手术病例。纳入有足够照片记录和随访的个体。排除既往或同时患有上睑、眼眶或眉部手术相关疾病的患者。利用公共领域软件根据照片计算边缘反射距离（MRD）。绘制数据进行检查并进行适当的统计检验。
在研究期间，198只眼符合分析标准。发现组织切除长度与手术前后MRD变化之间存在松散关联（r = 0.176，p < 0.05）；在方差分析中这种关系不显著（p = 0.367）。手术前后MRD变化与术前MRD之间存在强关联（r = 0.498，p < 0.01）。大约28%的样本在滴入2.5%去氧肾上腺素滴眼液后MRD增加超过2mm。去氧肾上腺素反应与术前MRD密切相关（r = -0.441，p < 0.01）。以组织切除、去氧肾上腺素反应>2mm和术前MRD为变量对手术前后MRD变化进行回归分析，结果显示仅术前MRD是唯一显著的预测因子（p < 0.01）。
在MMCR手术中，相对于术前MRD，组织切除长度和去氧肾上腺素反应在决定MRD变化方面作用较小。
