Evaluation of Graded Transcutaneous Levator Muscle Recession with Mullerectomy for Treatment of Upper Eyelid Retraction in Dysthyroid Patients

Abd Elmagid M. Tag Eldin, Ahmad H. And

doi:10.21608/ejhm.2018.9084

Evaluation of Graded Transcutaneous Levator Muscle Recession with Mullerectomy for Treatment of Upper Eyelid Retraction in Dysthyroid Patients

Document Type : Original Article

Author

Ahmad H. and Abd Elmagid M. Tag Eldin

Ophthalmic Department, Faculty of Medicine, Al-Azhar University

10.21608/ejhm.2018.9084

Abstract

Purpose: To evaluate the efficacy, advantages and disadvantages of graded transcutaneous levator muscle recession with mullerectomy for treatment of dysthyroid upper eyelid retraction.
Design: Randomized, prospective and interventional case series.
Methods: This prospective interventional case series comprised 20 eyes of ten patients. Inclusion criteria included patients with bilateral upper eyelid retraction, with or without other manifestations of thyroid orbitopathy, without diplopia and with stable thyroid state for at least 6 months. All patients were subjected to graded transcutaneous levator muscle recession with mullerectomy after full ophthalmological assessment. All patients included in the study have signed a written consent and the study has been approved by the ethical committee of AL-AZHAR faculty of medicine.
Results: Postoperatively the mean decrease of MRD1 was 2.87 mm. Mean improvement of lagophthalmos was 0.78 mm. Mean increase of upper lid crease height was 0.65mm. Good lid contour achieved in 85.9%. Temporal flare persisted in one lid (5%) and nasal ptosis was reported in two eye lids (10%).
Conclusion: According to this study graded transcutaneous mullerectomy with levator muscle recession is a good and a reliable surgical technique for correction of dysthyroid upper lid retraction and is successful as a lengthening procedure for retracted upper eyelid regardless the severity of retraction with significant symptomatic and cosmetic improvement.

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