Abstract
Aponeurotic blepharoptosis may be safely and effectively corrected by resection of Müller’s muscle. This surgery is thought to raise the upper lid by advancement of the levator muscle and aponeurosis. A particular feature of the technique is a consistently good postoperative eyelid contour, achieved through high placement of sutures on the tarsal plate. The open-sky technique offers advantages over other ptosis surgeries, including direct visualization of Müller’s muscle, opportunity for adjustment of lid height, the potential for preservation of conjunctival tissue, and efficacy in patients who do not demonstrate a positive phenylephrine test.
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Beard C. Müller’s superior tarsal muscle; anatomy, physiology, and clinical significance. Ann Plast Surg. 1985;14:324–33.
Collin JRO. Ptosis repair of aponeurotic defects by the posterior approach. Br J Ophthalmol. 1979;63(8): 586–90.
Berke RN, Wadsworth JAC. Histology of levator muscle in congenital and acquired ptosis. Arch Ophthalmol. 1955;53:413.
Werb A. Ptosis. Aust J Ophthalmol. 1976;4:40.
Bang YH, Park SH, Kim JH, et al. The role of Müller’s muscle reconsidered. Plast Reconstr Surg. 1998; 101(5):1200–4.
Kiyoshi M. Stretching of the Müller muscle results in involuntary contraction of the levator muscle. Ophthal Plast Reconstr Surg. 2002;18(1):5–10.
Putterman AM, Urist MJ. Müller muscle-conjunctiva resection for treatment of blepharoptosis. Arch Ophthalmol. 1975;93:619–23.
Putterman AM, Urist MJ. Müller muscle-conjunctiva resection ptosis procedure. Ophthalmic Surg. 1978;9: 27–32.
Weinstein GS, Buerger Jr GF. Modifications of the Müller’s muscle-conjunctiva resection operation for blepharoptosis. Am J Ophtahlmol. 1982;93:647–51.
Putterman AM, Fett DR. Müller’s muscle in the treatment of upper eyelid ptosis – a ten year study. Ophthalmic Surg. 1986;17:354–60.
Karesh JW, Putterman AM, Fett DR. Conjunctiva-Müller’s muscle excision to correct anophthalmic ptosis. Ophthalmology. 1986;93(8):1068–71.
Guyuron B, Davies B. Experience with the modified Putterman procedure. Plast Reconstr Surg. 1988;82: 775–80.
Glatt HJ, Putterman AM, Fett DR. Müller’s muscle-conjunctival resection procedure in the treatment of ptosis in Horner’s syndrome. Ophthalmic Surg. 1990;21:93–6.
Dresner SC. Further modifications of the Müller’s muscle-conjunctival resection procedure for blepharoptosis. Ophthal Plast Reconstr Surg. 1991;7:114–22.
Press UP, Schayan-Araghi K, et al. Die Müller-Muskel-Resection: Indication, Technik und Ergebnisse. Ophthalmologe. 1994;91:533–5.
Lake S, Mohammad-Ali FH, Khooshabeh R. Open sky Müller’s muscle-conjunctiva resection for ptosis surgery. Eye. 2003;17(9):1008–12.
Baldwin HC, Bhagey J, Khooshabeh R. Open sky Müller’s muscle-conjunctival resection in phenylephrine test negative blepharoptosis patients. Ophthal Plast Reconstr Surg. 2005;21(4):276–80.
Khooshabeh R, Baldwin H. Isolated Müller’s muscle resection for the correction of blepharoptosis. Eye (Lond). 2008;22(2):267–72.
Shields M, Putterman A. Müller muscle-conjunctival resection: effect on tear production (Comment). Ophthal Plast Reconstr Surg. 2003;19:254–5.
Esmaeli-Gustein B, Hewlett BR, Pashby RC, et al. Distribution of adrenergic receptors subtypes in the retractor muscles of the upper eyelid. Ophthal Plast Recontr Surg. 1999;15:92–9.
Glatt HJ, Fett DR, Putterman AM. Comparison of 2.5% and 10% phenylephrine in the evaluation of upper eyelids with ptosis. Ophthalmic Surg. 1990;21: 173–6.
Buckman G, Jacobiec FA, Hyde K, et al. Success of the Fasanella-Servat operation independent of Müller’s smooth muscle excision. Ophthalmology. 1989;96:413–8.
Mercadetti M, Putterman AM, Cohen ME, et al. Internal levator advancement by Müller’s muscle-conjunctival resection: technique and review. Arch Facial Plast Surg. 2001;3(2):104–10.
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Baldwin, H. (2011). Open-Sky (Anterior Approach) Müller’s Muscle Resection for the Correction of Blepharoptosis. In: Cohen, A., Weinberg, D. (eds) Evaluation and Management of Blepharoptosis. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92855-5_20
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DOI: https://doi.org/10.1007/978-0-387-92855-5_20
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