External Levator Advancement v Müller’ Mucle–Conjunctival Reection for Correction of Upper Eyelid Involutional Ptoi

Purpoe To compare external levator advancement and Müller’ mucle–conjunctival reection (conjunctivomullerectomy, or CJM) for correction of upper eyelid involutional ptoi. Deign Retropective, nonrandomized, comparative interventional cae erie. Method Review of medical record of 159 patient (272 urgical procedure) who underwent external levator advancement or CJM wa performed. main outcome meaure: Functional and cometic outcome, marginal reflex ditance one (MRD1), and urgical complication. Reult A total of 159 patient (51 men, 108 women, mean age 70 year) underwent 272 urgical procedure for upper eyelid ptoi; concurrent blepharoplaty wa performed in 141 cae. MRD1 increaed an average of 1.6 (±1.5) mm, from 0.8 mm (±1.2) preoperatively to 2.3 mm (±1.2) potoperatively (P < .001). Fifteen patient (5.5%) underwent reoperation for reidual ptoi, nine (18%) in the external levator advancement group, two (3%) in the CJM group, three (8%) in the external plu blepharoplaty group, and one (1%) in the CJM plu blepharoplaty group (P < .001). Patient who underwent external levator advancement had ignificantly more evere ptoi preoperatively but attained imilar eyelid poition potoperatively a compared with CJM patient. Complication included overcorrection in four cae (1.4%), lagophthalmo of 1 mm in 10 (3.6%), and pyogenic granuloma in two (<1%). Concluion External levator advancement and CJM performed alone or with concurrent blepharoplaty are effective treatment for upper eyelid ptoi. Reidual ptoi or potoperative eyelid retraction occur in up to 20% of cae and can be addreed uccefully with a econd operation.