Predictability of conjunctival-Müellerectomy for blepharoptosis repair

Orbit. 2007 Dec;26(4):217-21. doi: 10.1080/01676830601169205.


Purpose: To assess the predictability of the algorithm used to determine the amount of tissue resection for conjunctival-Müellerectomy during blepharoptosis repair.

Methods: A consecutive case series of all patients undergoing conjunctival-Müellerectomy during blepharoptosis repair between July 2001 and February 2005. All of the cases had a positive phenylephrine test, and the mean preoperative upper marginal reflex distance (MRD1) was +1.60 mm (range: -1 +/-3.5 mm). Each patient underwent excision according to the following algorithm: 10 mm of resection for 2 mm of ptosis, 8 mm of resection for 1.5 mm of ptosis, and 6 mm of resection for 1 mm of ptosis.

Results: Fifty-five patients underwent conjunctival-Müellerectomy during blepharoptosis repair on 73 eyelids, using the above algorithm. Thirty-seven cases were unilateral and 18 were bilateral. The mean postoperative MRD1 was +3.42 mm (range 0-+4.5 mm). Postoperative symmetry was found in 42 of 55 patients (76.4%) after one surgical procedure. Patient satisfaction based on contour, symmetry and height after one repair was achieved in 52 of 55 patients (94.55%). There were three reoperations for previous undercorrection.

Conclusion: This algorithm quantifies conjunctival-Müellerectomy during blepharoptosis repair. Excellent and very predictable results are obtained by a technique that is both simple and achievable in a short operating time.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Blepharoplasty / methods*
  • Blepharoptosis / diagnosis
  • Blepharoptosis / surgery*
  • Child
  • Conjunctiva / surgery*
  • Eyelids / surgery
  • Facial Muscles / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phenylephrine
  • Treatment Outcome


  • Phenylephrine