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Surgical Technique
April 2001

Internal Levator Advancement by Müller's Muscle–Conjunctival ResectionTechnique and Review

Author Affiliations

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.

 

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.

Arch Facial Plast Surg. 2001;3(2):104-110. doi:
Abstract

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 was derived.

Conclusion  The surgeon will need to modify the table based on his or her clinical experience and postoperative results.

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