Response to phenylephrine testing in upper eyelids with ptosis

Lee, Grace; Lin, Lung‐Chang; Mehta, Sonia; Sk, Freitag

doi:10.5693/djo.01.2015.05.001

Cited by 17 publications

(20 citation statements)

References 13 publications

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“…In fact, the sympathomimetic effect of Phenylephrine theoretically involves only the action of M€ uller's muscle, so it is curious that levator function also affects the outcome of M€ uller's muscle resection, being mainly recommended in ptosis with normal levator function that correct with Phenylephrine. This may be attributable to the probability that partial M€ ullerectomy also includes some degree of plication of the posterior aspect of the levator aponeurosis (Lee et al 2015). Already in 1989, Buckman et al (1989) postulated that success might result from vertical posterior lamellar shortening, secondary contractile cicatrization of the wound, or advancement of the Muller's musclelevator aponeurosis complex on the tarsus.…”

Section: Discussionmentioning

confidence: 99%

“…The Phenylephrine test is commonly used in the evaluation of ptotic patients and their suitability for internal ptosis repair, and it is well documented that preoperative response to topical Phenylephrine is an important criterion for successful MMCR ptosis repair. During Phenylephrine testing, the sympathetically innervated M€ uller's muscle contracts and elevates the lid when exposed to topical Phenylephrine, an alpha-adrenergic agonist (Ben Simon et al 2005;Lee et al 2015;Couch 2016;Barsegian et al 2018).…”

Section: Introductionmentioning

confidence: 99%

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Effect of topical Phenylephrine on the upper eyelid crease position

Queirós

Won-Kim

Sales-Sanz

et al. 2020

Acta Ophthalmologica

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Purpose To investigate the effect of Phenylephrine test on the upper eyelid crease position. Material and Methods This study follows a prospective and analytical design and included patients with unilateral acquired involutional ptosis recruited between January 2015 and January 2018. In the Phenylephrine test, 1 drop of Phenylephrine 10% was instilled on the inferior fornix of the ptotic eye and the eyelid crease position was evaluated 10 min after. Results A total of 60 patients were included in the final sample. The mean Margin‐to‐reflex distance 1 (MRD1) of the ptotic eye was 2.1 ± 1.0 and 3.8 ± 0.6 mm before and 10 min after the instillation of Phenylephrine, respectively. The difference between the means was statistically significant (p < 0.001). Ninety‐five per cent of the eyes had a positive Phenylephrine test result. Of this, 100% showed a decrease in the height of eyelid crease after the drop. There was a statistically significant decrease in the height of eyelid crease from 10.3 ± 2.5 to 7.8 ± 2.0 mm (p < 0.001). Conclusion Phenylephrine test not only affects the eyelid position but also the eyelid crease height. We show a significative decrease in eyelid crease height to a symmetrical level with the contralateral lid in all patients that had a positive Phenylephrine test result. This effect is probably due to a posterior lamella shortening secondary to Müller’s muscle contraction and suggests that the eyelid crease is not only determined by the projections of levator aponeurosis, but also by the entire force vector of the upper eyelid retractors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of topical Phenylephrine on the upper eyelid crease position

Queirós

Won-Kim

Sales-Sanz

et al. 2020

Acta Ophthalmologica

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“…Lee и соавт. при изучении влияния степени птоза и функции мышцы, поднимающей верхнее веко, на результат ФЭ-теста, не отметили достоверных различий в ответе на тест [12].…”

Section: Discussionunclassified

Influence of Various Factors on Results on Phenylephrine Test

Потемкин

Goltsman

2020

Oftalʹmologiâ

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Phenylephrine test is one of the main factors determining the possibility of performing superior tarsal muscle resection. However, the influence of various factors on its result remains unexplored.Aim. To evaluate the effect of patient age, degree of ptosis, and levator muscle function on the result of the phenylephrine test.Patients and methods. 45 patients were examined (64 eyelids). The following examinations were performed for all patients: assessment of the degree of ptosis, levator muscle function and the phenylephrine test.Results. Age and the degree of ptosis do not affect the results of the phenylephrine test. Reduced levator muscle function leads to a decrease of the phenylephrine test results.Conclusion. The phenylephrine test remains an important criteria for patient selection for the planning superior tarsal muscle resection. Levator muscle function does affect the phenylephrine test result.

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“…Preoperative response to topical phenylephrine is a helpful indicator for successful Müller's muscle resection (MMR) ptosis repair. 75,76 During phenylephrine testing, topical phenylephrine hydrochloride…”

Section: Phenylephrine Hydrochloride Ophthalmic Dropsmentioning

confidence: 99%