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To the Editor.
—I read with interest Dr Sisler's article in the May Archives (1982;100:800-801) on the surgical correction of blepharoptosis in dry-eyed patients. Although I find it commendable to show concern for the preservation of tear-producing tissue, I do not believe that Dr Sisler's article supports his conclusions. The preservation by reimplantation (in the lower lid) of the tarsoconjunctiva specimen (as obtained by a Fasanella-Servat type procedure) prevents worsening of sicca in patients with previously dry eyes. First, the four patients described as dry eyed, did not, in my opinion, meet good criteria for that diagnosis. The author states only that the four patients had Schirmer test results of below 10 mm of wetting. This does not necessarily mean these patients had dry eyes. In a study by Lamberts et al in the Archives (1979;97:1082-1085), 32 of 86 eyes of normal patients had Schirmer No. 1 test results of
Lamberts DW. Conjunctivitis Sicca. Arch Ophthalmol. 1983;101(3):485. doi:10.1001/archopht.1983.01040010485035