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Article: Surgical microanatomy of the Müller muscle-conjunctival resection ptosis procedure

TitleSurgical microanatomy of the Müller muscle-conjunctival resection ptosis procedure
Authors
Issue Date2010
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.op-rs.com
Citation
Ophthalmic Plastic And Reconstructive Surgery, 2010, v. 26 n. 5, p. 360-364 How to Cite?
AbstractPurpose: To assess for alterations in the microscopic anatomy that occur as a result of the Müller muscle-conjunctival resection (MMCR) ptosis procedure and to better understand the mechanisms by which MMCR elevates the eyelid. Methods: Sixteen orbits from 8 fresh frozen Caucasian cadaver heads, ranging from 38 to 100 years of age were used. For each head, MMCR was performed on one side. The contralateral, unoperated orbit served as an anatomic control. Each exenterated orbital contents and excised MMCR specimen was evaluated. The histopathology of the eyelids and MMCR specimens were studied microscopically by staining with hematoxylin-eosin, elastic, and Verhoeff-Masson trichrome. Results: Müller muscle and conjunctiva were present in all 8 of the excised MMCR specimens. Elastic fibers consistent with Müller muscle tendon or among the smooth muscle fibers were seen within all excised MMCR specimens. The levator aponeurosis was intact in 8 of 8 operated eyelids; however, the aponeurosis was plicated in all. The accessory lacrimal gland tissues were intact in all of the operated and unoperated eyelids. Conclusions: MMCR works by shortening the posterior lamella, which results in advancement of the levator palpebrae superioris muscle and plication of the levator aponeurosis. Plication of the levator aponeurosis likely contributes to the increased volumetric effect seen clinically after MMCR. Phenylephrine testing can help in fine-tuning the amount of resection, but given the mechanism of action of MMCR, adequate levator muscle function remains a critical factor in the success of the surgery. Moreover, MMCR preserves accessory lacrimal gland tissues. © 2010 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/127681
ISSN
2015 Impact Factor: 0.991
2015 SCImago Journal Rankings: 0.630
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMarcet, MMen_HK
dc.contributor.authorSetabutr, Pen_HK
dc.contributor.authorLemke, BNen_HK
dc.contributor.authorCollins, MEen_HK
dc.contributor.authorFleming, JCen_HK
dc.contributor.authorWesley, REen_HK
dc.contributor.authorPinto, JMen_HK
dc.contributor.authorPutterman, AMen_HK
dc.date.accessioned2010-10-31T13:39:51Z-
dc.date.available2010-10-31T13:39:51Z-
dc.date.issued2010en_HK
dc.identifier.citationOphthalmic Plastic And Reconstructive Surgery, 2010, v. 26 n. 5, p. 360-364en_HK
dc.identifier.issn0740-9303en_HK
dc.identifier.urihttp://hdl.handle.net/10722/127681-
dc.description.abstractPurpose: To assess for alterations in the microscopic anatomy that occur as a result of the Müller muscle-conjunctival resection (MMCR) ptosis procedure and to better understand the mechanisms by which MMCR elevates the eyelid. Methods: Sixteen orbits from 8 fresh frozen Caucasian cadaver heads, ranging from 38 to 100 years of age were used. For each head, MMCR was performed on one side. The contralateral, unoperated orbit served as an anatomic control. Each exenterated orbital contents and excised MMCR specimen was evaluated. The histopathology of the eyelids and MMCR specimens were studied microscopically by staining with hematoxylin-eosin, elastic, and Verhoeff-Masson trichrome. Results: Müller muscle and conjunctiva were present in all 8 of the excised MMCR specimens. Elastic fibers consistent with Müller muscle tendon or among the smooth muscle fibers were seen within all excised MMCR specimens. The levator aponeurosis was intact in 8 of 8 operated eyelids; however, the aponeurosis was plicated in all. The accessory lacrimal gland tissues were intact in all of the operated and unoperated eyelids. Conclusions: MMCR works by shortening the posterior lamella, which results in advancement of the levator palpebrae superioris muscle and plication of the levator aponeurosis. Plication of the levator aponeurosis likely contributes to the increased volumetric effect seen clinically after MMCR. Phenylephrine testing can help in fine-tuning the amount of resection, but given the mechanism of action of MMCR, adequate levator muscle function remains a critical factor in the success of the surgery. Moreover, MMCR preserves accessory lacrimal gland tissues. © 2010 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.op-rs.comen_HK
dc.relation.ispartofOphthalmic Plastic and Reconstructive Surgeryen_HK
dc.titleSurgical microanatomy of the Müller muscle-conjunctival resection ptosis procedureen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0740-9303&volume=26&spage=360&epage=364&date=2010&atitle=Surgical+Microanatomy+of+the+Muller+Muscle-Conjunctival+Resection+Ptosis+Procedureen_HK
dc.identifier.emailMarcet, MM: marcet@hku.hken_HK
dc.identifier.authorityMarcet, MM=rp01363en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/IOP.0b013e3181cb79a2en_HK
dc.identifier.pmid20622700-
dc.identifier.scopuseid_2-s2.0-77957374554en_HK
dc.identifier.hkuros183046en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77957374554&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume26en_HK
dc.identifier.issue5en_HK
dc.identifier.spage360en_HK
dc.identifier.epage364en_HK
dc.identifier.eissn1537-2677-
dc.identifier.isiWOS:000282003200013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMarcet, MM=8891087900en_HK
dc.identifier.scopusauthoridSetabutr, P=24391718900en_HK
dc.identifier.scopusauthoridLemke, BN=7007084465en_HK
dc.identifier.scopusauthoridCollins, ME=36875386100en_HK
dc.identifier.scopusauthoridFleming, JC=7401457682en_HK
dc.identifier.scopusauthoridWesley, RE=7103154073en_HK
dc.identifier.scopusauthoridPinto, JM=7402584711en_HK
dc.identifier.scopusauthoridPutterman, AM=7005408043en_HK

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