Confusion about what a mullerectomy is based on web searches

Question

Hello, I would like clarity on what a mullerectomy is and whether it lowers or elevates the eyelid. The reason for asking is that based on web searches it appears this procedure can be used to lower the eyelid in cases like Graves', but then it also appears the same procedure can be used to elevate the eyelid to treat ptosis. Are there different types of mullerectomies? Please explain, thanks!

C. Blake Perry, MD · Answer

The Muller’s muscle can be manipulated to elevate or lower the eyelid.
Typically, a Mullerectomy (or internal ptosis repair) is used to raise a droopy upper lid. During this procedure the upper lid everted, conjunctiva and Muller’s muscle is excised, and sutures are then placed. This effectively tightens Muller’s muscle and raises the lid.
For upper lid retraction repair, Muller’s muscle is disinserted from the tarsus to help lower lid.
Best to see an eyelid expert.

Kenneth D. Steinsapir, MD · Answer

A Mullerectomy is a very popular ptosis surgery. Also called a Mueller's muscle conjunctival resection ptosis surgery (MMCR). This surgery is massively over used by eyelid surgeons because it is quick and simple. If you believe the literature, it is highly reliable. It is popular and it is quick but it is far from reliable. Many, many ptotic eyelids also need the crease corrected and this surgery will not accomplish this. Many of these eyelids warrant an anterior levator resection ptosis surgery with eyelid crease reconstruction but that requires a level of finesse that many eyelid surgeons don't possess. Now don't confuse this with a Mullerotomy which is a must less frequently performed surgery for upper eyelid retraction (eyelids that are too open). Mullerectomy is a ptosis surgery and Mullerotomy is a surgery for upper eyelid retraction.

Jennifer Goodrich, MD · Answer

Good morning. In general, there are 2 different treatments for ptosis (excluding congenital ptosis): levator advancement or muellerectomy. Both procedures are used in ptosis repair to elevate the eyelid margin. Hope this helps!

Confusion about what a mullerectomy is based on web searches

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