Bautista Sana Ali, Wladis Edward J, Schultze Robert L
Department of Ophthalmology.
Ophthalmic Plastic Surgery, Department of Ophthalmology, Lions Eye Institute.
Ophthalmic Plast Reconstr Surg. 2018 Nov/Dec;34(6):562-564. doi: 10.1097/IOP.0000000000001103.
Müller's muscle-conjunctival resection (MMCR) is a highly effective technique to correct upper eyelid ptosis. However, several authorities have raised concerns about the possibility of postoperative ocular surface dryness. This study was performed to assess the impact of MMCR on clinically meaningful parameters of the ocular surface.
In adult patients, tear break-up time, lipid layer thickness, and osmolarity were measured via direct observation, interferometry, and impedance measurements before surgery and 3 months after surgery in patients who underwent MMCR. Statistical analysis was performed via a dedicated software package.
Fifteen eyes of 14 patients were included in the study. Mean pre- and postoperative tear break-up times were 12.71 ± 2.20 and 12.43 ± 2.41 seconds, respectively (p = 0.1648). Preoperatively, the mean lipid layer thickness measurement was 91.00 ± 7.02 nm, whereas the mean postoperative value was 88.86 ± 21.36 nm (p = 0.6613). The mean preoperative tear osmolarity measured 291.4 ± 8.86 mOsm/l, and the mean postoperative measurement was 289.86 ± 9.74 mOsm/l (p = 0.2652).
MMCR does not appear to change clinically meaningful ocular surface disease parameters, and postoperative dryness did not result from this procedure. In appropriately selected patients, MMCR can be safely performed without increased concerns regarding postoperative dry eye disease.
米勒肌-结膜切除术（MMCR）是一种矫正上睑下垂的高效技术。然而，一些权威人士对术后眼表干燥的可能性表示担忧。本研究旨在评估MMCR对眼表具有临床意义的参数的影响。
在成年患者中，对接受MMCR的患者在手术前和术后3个月通过直接观察、干涉测量法和阻抗测量法测量泪膜破裂时间、脂质层厚度和渗透压。通过专用软件包进行统计分析。
14例患者的15只眼纳入研究。术前和术后平均泪膜破裂时间分别为12.71±2.20秒和12.43±2.41秒（p = 0.1648）。术前脂质层厚度平均测量值为91.00±7.02纳米，而术后平均测量值为88.86±21.36纳米（p = 0.6613）。术前泪液渗透压平均测量值为291.4±8.86毫摩尔/升，术后平均测量值为289.86±9.74毫摩尔/升（p = 0.2652）。
MMCR似乎不会改变具有临床意义的眼表疾病参数，且该手术不会导致术后干眼。在适当选择的患者中，可以安全地进行MMCR，而无需增加对术后干眼病的担忧。
