Levator Resection for Minimal Ptosis: Another Simplified Operation

Fasanella, R. M.; Servat, Javier

doi:10.1001/archopht.1961.01840020495005

Cited by 245 publications

(96 citation statements)

References 4 publications

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“…It is used to treat upper eyelid ptosis and may be combined with blepharoplasty (Putterman and Urist 1975;Foster et al 2006;Michels et al 2007;Georgescu et al 2008). The Fasanella-Servat procedure was introduced for cases of minimal blepharoptosis with good levator function (Fasanella and Servat 1961). A clinically important piece of data for the diagnosis of blepharoptosis is the margin reflex distance (MRD) that is synonymous of midpupil-to-upper eyelid distance.…”

Section: Discussionmentioning

confidence: 99%

The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations

et al. 2009

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The superior tarsal muscle (STM) is a smooth muscle that originates from the undersurface of the levator palpebrae superioris muscle (LPSM) and inserts onto the superior tarsal plate (STP) of the upper eyelid. We have performed a morphometrical investigation of the STM in 49 adult human cadavers (34 males, 15 females). Histological analysis has shown a transitional area between the skeletal striated muscle (LPSM) and the adjacent smooth muscle (STM). We propose an original morphological classification based upon the attachment of STM to the upper border of the STP. Accordingly, we describe four patterns of STM. Pattern 1 (P1) consists of STM attachment to the central portion of the STP. Pattern 2 consists of both medial (P2M) STM attachment to both the central and medial regions of the STP and lateral (P2L) STM attachment to both the central and lateral regions of the STP. Pattern 3 (P3) consists of STM attachment along the whole extent of the STP. Pattern 3 was the most frequently observed pattern (63.27%) followed by patterns P2M (24.49%), P2L (8.16%) and P1 (4.08%). P3 was the predominant pattern in males (73.52%), while in females, both patterns P2M (46.66%) and P3 (40.00%) were equally prevalent. The analysis of paired specimens revealed a symmetrical arrangement in 72.20% of all cases, with the remaining cases (27.80%) displaying left-right STM asymmetries. To the best of our knowledge, this is the first description of the STM asymmetries in the medical literature. This innovative classification provides anatomical parameters for interpreting morphological variations of the STM with relevant applications in both plastic surgery and ophthalmology.

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Section: Discussionmentioning

confidence: 99%

The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations

et al. 2009

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“…4 It is only suitable for mild ptosis of less than 3 mm. 5 Histopathology of the excised tissues has shown that usually tarsus is excised with no or minimal Mü ller's muscle.…”

Section: Introductionmentioning

confidence: 99%

Open sky Müller's muscle–conjunctiva resection for ptosis surgery

Lake

Mohammad-Ali

Khooshabeh

2003

Eye

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Purpose We describe a surgical technique for ptosis correction in moderate to good levator function involving resection of Mü ller's muscle of the upper eyelid. This is a substantial modification of the technique described by Putterman. We then present our experience of and the results from this method. Methods A subtotal resection of Mü ller's muscle plus underlying conjunctiva is performed under direct visualisation. The muscle stump is reattached to the tarsus and the sutures passed through to the skin crease. In those cases where the phenylephrine test was positive to a level less than the desired lid height, a 1 mm of strip of tarsus is included in the tissue resection. The sutures are removed between 5 days and 3 weeks postoperatively allowing control over lid height and contour. A total of 61 eyes of 48 patients underwent this procedure. Results Of 61 eyelids, 56 undergoing this procedure were within 0.5 mm of the desired end point, giving a success rate of 92%. Of 61 eyelids, 60 were within 1 mm of the desired height. Preoperative phenylephrine 10% was highly predictive of postoperative lid height (58/61). An excellent lid contour was noted in all cases (61/61). Conclusions We present a new approach to ptosis correction using Mü ller's muscle. It has a high success rate and good cosmetic outcome. It is technically straightforward and easy to learn.

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“…superior rectus and tarsal coupling by Motais and Parinaud in 1897, and conjunctival-tarsal-mullerectomy by Fasanella and Servat in 1961 [9]. The Fasanella-Servat operation was widely adopted as a faster, less technically demanding surgery for repair of blepharoptosis with predictable results [1,9].…”

Section: Discussionmentioning

confidence: 99%

“…Conventionally, the Fasanella-Servat operation has been employed for minimal ptosis with good levator function, and this is reflected in the published literature regarding outcomes of the Fasanella-Servat procedure [1][2][3][4][5]7,10]. We were curious regarding the utility of this operation in patients with moderate to severe ptosis, and we hereby present our experience with the Fasanella-Servat surgical repair of blepharoptosis in these patients.…”

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confidence: 99%

Fasanella-Servat Operation for Moderate to Severe Blepharoptosis

Gonzalez¹

2017

OCR

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Levator Resection for Minimal Ptosis: Another Simplified Operation

Cited by 245 publications

References 4 publications

The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations

The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations

Open sky Müller's muscle–conjunctiva resection for ptosis surgery

Fasanella-Servat Operation for Moderate to Severe Blepharoptosis

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