Successful Müller Muscle–Conjunctiva Resection in Patients With Boston Keratoprosthesis Type I

Lim, Janet; Bang, Genie M.; Cortina, María Soledad; Cruz, José de la; Setabutr, Pete

doi:10.1097/ico.0000000000000043

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Furthermore, lower lid laxity may negatively affect the corneal graft. 5 In our study, MMCR±T, combined with lateral tarsal strip procedure, was performed in 2 patients with eyelid laxity to improve the BCL position for adequate coverage of the corneal graft.…”

Section: Discussionmentioning

confidence: 95%

“…Eyelid ptosis may decrease the visual acuity and visual field that was improved with PK. 5,6 The main goal in these patients are to improve their vision and quality of life. The second goal is to achieve a satisfactory upper eyelid height and symmetry.…”

Section: Discussionmentioning

confidence: 99%

“…2 Overall, approximately 90% of all corneal transplantation procedures performed in 95 reporting countries are PK, regardless of the surgical indication. 3,4 Patients who undergo PK may experience eyelid ptosis [5][6][7] and blepharoptosis that may restrict the visual acuity and the visual field that was improved with the PK. 5,6 Subsequent correction of ptosis has been demonstrated to increase the patient quality of life, 8 but surgeons may be unwilling to treat ptosis because of concerns about complications resulting from lagophthalmos and exposure keratopathy.…”

Section: Introductionmentioning

confidence: 99%

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Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

Mangan

Ocak

Vural

et al. 2021

Korean J Ophthalmol

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Purpose To examine the efficacy of ptosis correction with a Müller muscle-conjunctival resection with or without tarsectomy (MMCR±T), combined with bandage contact lens (BCL) use, in corneal graft patients. Methods Seven patients with corneal grafts who underwent MMCR±T for treatment of ptosis were evaluated retrospectively. A BCL was applied to the grafts at the end of the surgery. The collected data included preoperative and postoperative visual acuity, marginal reflex distance 1 (MRD-1), presence of Hering’s dependency by the phenylephrine test, symmetry outcomes, and complications after MMCR±T. Results The average duration between the penetrating keratoplasty and MMCR±T was 14 months, with a follow-up time of 10.4 months after MMCR±T. Hering’s dependency was observed in four (57.2%) patients before MMCR±T, and MRD-1 was increased in all patients based on preoperative phenylephrine tests. The mean preoperative MRD-1 was −0.14 ± 0.55 mm, and the mean postoperative MRD-1 was 2.35 ± 0.89 mm ( p < 0.0001). Symmetry outcomes of perfect (<0.5 mm), good (0.5–1 mm), and fair (≥1 mm) were noted after MMCR±T in three, three, and one patients, respectively. During the follow-up, no obvious corneal epitheliopathy, keratitis, or corneal graft rejection/failure were noted in any cases. BCL use was well tolerated by all patients. Conclusions Most patients achieved good surgical outcomes with the application of the BCL to protect the graft and with the use of the phenylephrine test and Hering’s dependency to predict the final eyelid position and symmetry. MMCR±T combined with BCL may therefore represent an alternative approach for correction of ptosis in patients with corneal graft.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

Mangan

Ocak

Vural

et al. 2021

Korean J Ophthalmol

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“…Another high‐risk group for ocular surface compromise are patients with previous keratoprosthesis type 1. A small study assessed the outcomes of seven patients with KPro undergoing MMCR surgery, and found that none of the patients had complications, or any compromise to the conjunctival or donor cornea …”

Section: Can Posterior Approach Ptosis Surgery Be Used In High Risk Pmentioning

confidence: 99%

“…A small study assessed the outcomes of seven patients with KPro undergoing MMCR surgery, and found that none of the patients had complications, or any compromise to the conjunctival or donor cornea. 45 Mueller's muscle resection also appears to give good results for ptosis in the anophthalmic socket, 46 and it has been reported to be able to treat both giant fornix syndrome and ptosis in the anophthalmic socket simultaneously. 47 Whilst to the authors best knowledge, there are no studies in the literature regarding the use of ptosis surgery, specifically posterior ptosis surgery, in patients with cicatrizing conjunctival disease, the authors feel that a history of cicatrizing conjunctival disease is a true contra-indication to posterior approach ptosis surgery.…”

Section: Can Posterior Approach Ptosis Surgery Be Used In High Riskmentioning

confidence: 99%

How far we have come: A review of the evolution of posterior approach ptosis surgery

Ullrich

Malhotra

2019

Clinical Exper Ophthalmology

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We revisit the evolution of posterior approach ptosis surgery. We address the early attempts at ptosis surgery, assess the more modern approach by de Blaskovics, followed by the division into “open sky” and “closed” techniques. The simultaneous developments occurring in America and Europe are described, along with refinement of surgical approaches such as conjunctival‐sparing posterior approach ptosis surgery.

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Müller muscle-Conjunctival Resection (MMCR) Surgery: A Comprehensive Literature Review

Fatani,

Kamal,

AlSulaiman

2024

European Journal of Ophthalmology

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Purpose This literature review aims to provide a comprehensive overview of the current understanding, indications, techniques, outcomes, and complications of Müller muscle-conjunctival resection (MMCR) surgery. It also addresses areas of debate with MMCR such as predictability concerning Phenylephrine response as well as the amount of muscle resection required. Method This literature review was compiled based on the available evidence from PubMed from 1975 to August 2023. Results The success rate of MMCR ranges from 72% to 95%, with high patient satisfaction reported in most studies. The exact range of eyelid elevation after MMCR is variable, with a reported average of 2.1 mm MRD1 elevation. Conclusion MMCR is a well-established surgical technique used to correct upper eyelid ptosis that results from dysfunction or attenuation of the levator aponeurosis. MMCR proved to be a safe and effective procedure with a high patient satisfaction rate and low risk of complications.

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Successful Müller Muscle–Conjunctiva Resection in Patients With Boston Keratoprosthesis Type I

Cited by 3 publications

References 20 publications

Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft

How far we have come: A review of the evolution of posterior approach ptosis surgery

Müller muscle-Conjunctival Resection (MMCR) Surgery: A Comprehensive Literature Review

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