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Suzanne Freitag MD
Juan Carlos Jimenez Perez, MD
Benjamin Jastrzembski, MD
Harvard Medical School, Massachusetts Eye and Ear
Mullerectomy (Putterman müllerectomy, Müller muscle resection)
Repair of upper eyelid ptosis of up to 2mm
N/A
Putterman clamp
N/A
In the clinic, 2.5% phenylephrine hydrochloride is instilled into the eye with the ptotic upper eyelid. Adequate upper eyelid position fifteen minutes following the instillation of the drop suggests the ptosis is amenable to repair with the mullerectomy procedure. The marginal reflex distance (MRD1) should be determined before and after the instillation of phenylephrine. The use of a flash photograph is very helpful in documenting an improvement in eyelid position with phenylephrine.
N/A
Potential complications include undercorrection of the ptosis and lagophthalmos with risk of subsequent exposure keratopathy.
None
N/A
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