Quantitative Assessment of Dry Eye Parameters After Muller’s Muscle-Conjunctival Resection

Purpose: Muller's muscle-conjunctival resection (MMCR) is a highly effective technique to correct upper eyelid ptosis. However, several authorities have raised concerns about the possibility of postoperative ocular surface dryness. This study was performed to assess the impact of MMCR on clinically meaningful parameters of the ocular surface. Methods: In adult patients, tear break-up time, lipid layer thickness, and osmolarity were measured via direct observation, interferometry, and impedance measurements before surgery and 3 months after surgery in patients who underwent MMCR. Statistical analysis was performed via a dedicated software package. Results: Fifteen eyes of 14 patients were included in the study. Mean pre- and postoperative tear break-up times were 12.71 ± 2.20 and 12.43 ± 2.41 seconds, respectively (p = 0.1648). Preoperatively, the mean lipid layer thickness measurement was 91.00 ± 7.02 nm, whereas the mean postoperative value was 88.86 ± 21.36 nm (p = 0.6613). The mean preoperative tear osmolarity measured 291.4 ± 8.86 mOsm/l, and the mean postoperative measurement was 289.86 ± 9.74 mOsm/l (p = 0.2652). Conclusions: MMCR does not appear to change clinically meaningful ocular surface disease parameters, and postoperative dryness did not result from this procedure. In appropriately selected patients, MMCR can be safely performed without increased concerns regarding postoperative dry eye disease. Accepted for publication February 4, 2018. The research adhered to the tenets of the Declaration of Helsinki as amended in 2008. The abstract of this manuscript has been presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Annual Meeting, American Academy of Ophthalmology, New Orleans, Louisiana, November 10, 2017 Fall Scientific Symposium. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to: Sana Ali Bautista, M.D., Department of Ophthalmology, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208. E-mail: alis4@amc.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.