Rootman Daniel B, Sinha Kunal R, Goldberg Robert A
Division of Orbital and Ophthalmic Plastic Surgery, Doheny Eye Center.
Division of Orbital and Ophthalmic Plastic Surgery, Stein Eye Institute.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4):355-360. doi: 10.1097/IOP.0000000000000997.
This study compares the use of a standard 7 mm resection length to a variable 4:1 ratio of resection length to desired elevation nomogram when performing Muller's muscle conjunctival resection surgery.
In this cross-sectional case control study, 2 groups were defined. The first underwent Muller's muscle conjunctival resection surgery with a standard 7 mm resection length and the second underwent the same surgery with a variable resection length determined by a 4:1 ratio of resection length to desired elevation nomogram. Groups were matched for age (within 5 years) and sex. Pre- and postoperative photographs were measured digitally. Change in upper marginal reflex distance 1 (MRD1) and final MRD1 were the primary outcome measures. The study was powered to detect a 1 mm difference in MRD1 to a beta error of 0.95.
No significant preoperative differences between the groups were noted. No significant difference in final MRD1 (0.1 mm; p = 0.74) or change in MRD1 (0.2 mm; p = 0.52) was noted. Mean resection length to elevation ratios were 3.9:1 for standard group and 4.3:1 for the variable group (p = 0.54).
The authors were not able to detect a significant difference in final MRD1 or change in MRD1 for patients undergoing Muller's muscle conjunctival resection surgery with standard or variable resection lengths. These results tend to argue against a purely mechanical mechanism for Muller's muscle conjunctival resection surgery.
本研究比较了在进行米勒肌结膜切除术时，使用标准7毫米切除长度与采用切除长度与预期上睑提升的可变4:1比例列线图的情况。
在这项横断面病例对照研究中，定义了2组。第一组接受标准7毫米切除长度的米勒肌结膜切除术，第二组接受根据切除长度与预期上睑提升的4:1比例列线图确定可变切除长度的相同手术。两组在年龄（5岁以内）和性别上进行匹配。术前和术后照片进行数字测量。上睑缘反射距离1（MRD1）的变化和最终MRD1是主要结局指标。该研究旨在检测MRD1中1毫米的差异，β误差为0.95。
两组术前无显著差异。最终MRD1（0.1毫米；p = 0.74）或MRD1的变化（0.2毫米；p = 0.52）均无显著差异。标准组的平均切除长度与提升比例为3.9:1，可变组为4.3:1（p = 0.54）。
作者未能检测到接受标准或可变切除长度的米勒肌结膜切除术患者在最终MRD1或MRD1变化方面的显著差异。这些结果倾向于反对米勒肌结膜切除术的纯机械机制。
