From the Department of Ophthalmology and Visual Sciences, University
of Illinois at Chicago, and Michael Reese Hospital, Chicago, Ill (Drs Mercandetti
and Putterman); Department of Information Systems and Decision Sciences, University
of South Florida, Tampa (Dr M. E. Cohen); Coastal Ear, Nose, and Throat, Ormond
Beach, Fla (Dr Mirante); and Division of Ophthalmology, Nassau County Medical
Center, East Meadow, NY (Dr A. J. Cohen). Dr Mercandetti is now with Ophthalmic
Consultants, Sarasota, Fla.
Background Müller's muscle–conjunctival resection surgery presumably
works by advancing the levator aponeurosis of the upper eyelid. The amount
of blepharoptosis and the lid's response to the instillation of phenylephrine
hydrochloride onto the superior ocular fornix are used to determine the extent
of surgery needed.
Objectives To demonstrate the procedure developed and popularized by Allen M. Putterman,
MD, performed by Michael Mercandetti, MD, MBA, and to describe the relationship
between the amount of Müller's muscle–conjunctival resection performed
and the amount of elevation achieved.
Methods Data were retrospectively analyzed based on surgical cases done over
a 5-year period by one surgeon (A.M.P.).
Results A linear regression model was developed. From this regression a simple
table correlating the amount of resection with the amount of elevation desired
Conclusion The surgeon will need to modify the table based on his or her clinical
experience and postoperative results.
Mercandetti M, Putterman AM, Cohen ME, Mirante JP, Cohen AJ. Internal Levator Advancement by Müller's Muscle–Conjunctival ResectionTechnique and Review. Arch Facial Plast Surg. 2001;3(2):104-110. doi: