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Muller Kası Konjonktival Rezeksiyon Cerrahisi: Yeni Bir Method İle Cerrahi Sonuçların Değerlendirilmesi

Yıl 2024, Cilt: 46 Sayı: 2, 183 - 189, 18.03.2024
https://doi.org/10.20515/otd.1390887

Öz

Çalışmanın amacı Muller kası konjonktiva rezeksiyon (MKKR) cerrahisi sonrasında üst göz kapağı pozisyonunu oto-refraktometre (OR) ön monitör görüntüleri (ÖMG) kullanarak uygulanan daha standardize ve objektif bir method ile değerlendirmektir. Ocak 2020 ile Nisan 2023 tarihleri arasında 6 mm veya 8 mm MKKR cerrahisi uygulanan hastaların tıbbi kayıtları incelendi. Oto-refrektometre ön monitör görüntüleri cerrahi öncesinde ve takip sürecinde olgulardan alındı. Margin reflex distance 1 (MRD1) değeri OR-ÖMG ve ImageJ proğramı kullanılarak ölçüldü. Başarı ölçüsü preoperatif ve postoperatif ortalama OR-MRD1 değerleri kullanılarak belirlendi. Çalışmaya dahil edilen 34 kişiden 14' ü 6 mm MKKR, 20' si 8 mm MKKR cerrahisi geçirmiş idi. Ortalama preoperatif OR-MRD1 değeri 6 mm rezeksiyon grubunda 2.1  0.8 mm ve 8 mm rezeksiyon grubunda 2,3  0,7 mm idi, ancak gruplar arasında istatistiksel olarak anlamlı değildi (p: 0,45). Cerrahi sonrası ortalama OR-MRD1 değeri 6 mm rezeksiyon grubunda 8 mm rezeksiyon grubuna göre daha yüksek idi, ancak fark istatistiksel olarak anlamlı değildi (p: 0.14). Ortalama OR-MRD1 farkı 6 mm rezeksiyon grubunda 1.4  0.2 mm ve 8 mm rezeksiyon grubunda 1.1  0.3 mm idi, ancak fark istatistiksel olarak anlamlı değildi (p: 0.09). Üst göz kapağı pozisyon değişikliği analizine göre (daha kolay ulaşılabilir, kost-effektif ve standardize bir yöntem kullanılarak ölçülen), MKKR cerrahisi sonrasında eksize edilen doku miktarı ile final üst göz kapağı pozisyonu arasında direkt bir ilişki yok idi ve mevcut literatür ile uyumlu olarak MKKR cerrahisi mekanik bir durumdan çok dinamik bir durumu tanımlamaktadır.

Kaynakça

  • 1. Bacharach J, Lee WW, Harrison AR, Freddo TF. A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options. Eye (Lond). 2021;35(9):2468-81.
  • 2. Cohen LM, Rootman DB. Blepharoptosis Repair: External Versus Posterior Approach Surgery: Why I Select One over the Other. Facial Plast Surg Clin North Am. 2021;29(2):195-208.
  • 3. Allen RC, Saylor MA, Nerad JA. The current state of ptosis repair: a comparison of internal and external approaches. Curr Opin Ophthalmol. 2011;22(5):394-9.
  • 4. Rootman DB, Sinha KR, Goldberg RA. Change in Eyelid Position Following Muller's Muscle Conjunctival Resection With a Standard Versus Variable Resection Length. Ophthalmic Plast Reconstr Surg. 2018;34(4):355-60.
  • 5. Zloto O, Kapelushnik N, Sharon T, Prat D, Leshno A, Ben Simon G. The Effect of Upper Eyelid Muller Muscle Conjunctival Resection Surgery on Lower Eyelid Position. Curr Eye Res. 2021;46(7):949-53.
  • 6. Nacaroglu SA, Karabulut GO, Fazil K, Serefoglu Cabuk K, Kandemir Besek N, Taskapili M. Comparing the outcome of Muller's muscle conjunctival resection for mild/moderate versus severe involutional aponeurotic ptosis. Eur J Ophthalmol. 2021;31(6):3436-41.
  • 7. Dryden SC, Rho JE, Fowler SC, Gannon EW, Houser KH, Fleming JC, et al. Postoperative Clinical Outcomes Using Standard Variables Following Levator-Mullerectomy Advancement Blepharoptosis Surgery. J Craniofac Surg. 2021;32(6):e554-e6.
  • 8. Karadeniz Ugurlu S, Karakas M. Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy. Turk J Ophthalmol. 2017;47(3):149-55.
  • 9. Nemet AY. Accuracy of Marginal Reflex Distance Measurements in Eyelid Surgery. J Craniofac Surg. 2015;26(7):e569-71.
  • 10. Zheng X, Kakizaki H, Goto T, Shiraishi A. Digital Analysis of Eyelid Features and Eyebrow Position Following CO(2) Laser-assisted Blepharoptosis Surgery. Plast Reconstr Surg Glob Open. 2016;4(10):e1063.
  • 11. Boboridis K, Assi A, Indar A, Bunce C, Tyers AG. Repeatability and reproducibility of upper eyelid measurements. Br J Ophthalmol. 2001;85(1):99-101.
  • 12. Ogasawara K. Application of Second-Generation Swept-Source Anterior Segment-OCT in the Measurement of Marginal Reflex Distance-1 (MRD-1). Clin Ophthalmol. 2020;14:635-42.
  • 13. Rufer F, Schroder A, Erb C. White-to-white corneal diameter: normal values in healthy humans obtained with the Orbscan II topography system. Cornea. 2005;24(3):259-61.
  • 14. Kovacic Z, Ivanisevic M, Plestina-Borjan I, Capkun V. [Automatic refractometry, reliability of the determination of type and degree of refraction anomalies]. Lijec Vjesn. 1998;120(6):162-4.
  • 15. Yolcu D, Ozdogan S. A novel method to measure margin reflex distance using the autorefractometer. Int Ophthalmol. 2022;42(4):1241-7.
  • 16. Roelofs KA, Margines JB, Chen T, Goodyear K, Goldberg RA, Rootman DB. Optimizing Management of Asymmetric Ptosis: A Comparison of Three Posterior Approach Resection Algorithms. Ophthalmic Plast Reconstr Surg. 2023;39(1):72-5.
  • 17. Dan J, Sinha KR, Rootman DB. Predictors of Success Following Muller's Muscle-Conjunctival Resection. Ophthalmic Plast Reconstr Surg. 2018;34(5):483-6.
  • 18. Leung VC, Dupuis JE, Ashraf DC, Idowu OO, Massicotte E, Vagefi MR, et al. Muller Muscle Conjunctival Resection: A Multicentered Prospective Analysis of Surgical Success. Ophthalmic Plast Reconstr Surg. 2023;39(3):226-31.
  • 19. Nishihira T, Ohjimi H, Eto A. A new digital image analysis system for measuring blepharoptosis patients' upper eyelid and eyebrow positions. Ann Plast Surg. 2014;72(2):209-13

Muller’s Muscle Conjunctival Resection Surgery: Assessment of The Surgical Outcomes By Using a Novel Method

Yıl 2024, Cilt: 46 Sayı: 2, 183 - 189, 18.03.2024
https://doi.org/10.20515/otd.1390887

Öz

The aim of the study was to analyze the upper eyelid position following the Muller’s muscle conjunctival resection (MMCR) surgery by using a more standardized and objective method which was obtained by using the autorefractometer (AR) front monitor image (FMI).: Medical records of the patients who underwent either 6 mm or 8 mm MMCR surgery between January 2020 to April 2023 were evaluated. The AR-FMIs were obtained before the surgery and during the follow-up period. The margin reflex distance 1 (MRD1) was measured by using the AR-FMI and ImageJ software. Outcome measures were derived from preoperative and postoperative mean AR-MRD1 values. Out of 34 subjects, 14 underwent 6 mm MMCR surgery and 20 underwent 8 mm MMCR surgery. Mean preoperative AR-MRD1 was 2.1  0.8 mm in the 6 mm resection group, and 2.3  0.7 mm in the 8 mm resection group and there was no statistically significant difference among the groups (p: 0.45). The mean postoperative AR-MRD1 value was higher in the 6 mm resection group when compared with the 8 mm resection group, however the difference was not statistically significant (p: 0.14). The mean AR-MRD1 difference was 1.4  0.2 mm in the 6 mm resection group and 1.1  0.3 mm in the 8 mm resection group, however, the difference was not significant (p: 0.09). According to the upper eyelid position change analysis (which was measured by using an easily evaluable, cost-effective and standardized method), the amount of the excised tissue following the MMCR surgery and final upper eyelid position was not associated directly and the result supported the current literature which propose that, changes in the upper eyelid position following the MMCR is a dynamic process rather than the mechanical process.

Kaynakça

  • 1. Bacharach J, Lee WW, Harrison AR, Freddo TF. A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options. Eye (Lond). 2021;35(9):2468-81.
  • 2. Cohen LM, Rootman DB. Blepharoptosis Repair: External Versus Posterior Approach Surgery: Why I Select One over the Other. Facial Plast Surg Clin North Am. 2021;29(2):195-208.
  • 3. Allen RC, Saylor MA, Nerad JA. The current state of ptosis repair: a comparison of internal and external approaches. Curr Opin Ophthalmol. 2011;22(5):394-9.
  • 4. Rootman DB, Sinha KR, Goldberg RA. Change in Eyelid Position Following Muller's Muscle Conjunctival Resection With a Standard Versus Variable Resection Length. Ophthalmic Plast Reconstr Surg. 2018;34(4):355-60.
  • 5. Zloto O, Kapelushnik N, Sharon T, Prat D, Leshno A, Ben Simon G. The Effect of Upper Eyelid Muller Muscle Conjunctival Resection Surgery on Lower Eyelid Position. Curr Eye Res. 2021;46(7):949-53.
  • 6. Nacaroglu SA, Karabulut GO, Fazil K, Serefoglu Cabuk K, Kandemir Besek N, Taskapili M. Comparing the outcome of Muller's muscle conjunctival resection for mild/moderate versus severe involutional aponeurotic ptosis. Eur J Ophthalmol. 2021;31(6):3436-41.
  • 7. Dryden SC, Rho JE, Fowler SC, Gannon EW, Houser KH, Fleming JC, et al. Postoperative Clinical Outcomes Using Standard Variables Following Levator-Mullerectomy Advancement Blepharoptosis Surgery. J Craniofac Surg. 2021;32(6):e554-e6.
  • 8. Karadeniz Ugurlu S, Karakas M. Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy. Turk J Ophthalmol. 2017;47(3):149-55.
  • 9. Nemet AY. Accuracy of Marginal Reflex Distance Measurements in Eyelid Surgery. J Craniofac Surg. 2015;26(7):e569-71.
  • 10. Zheng X, Kakizaki H, Goto T, Shiraishi A. Digital Analysis of Eyelid Features and Eyebrow Position Following CO(2) Laser-assisted Blepharoptosis Surgery. Plast Reconstr Surg Glob Open. 2016;4(10):e1063.
  • 11. Boboridis K, Assi A, Indar A, Bunce C, Tyers AG. Repeatability and reproducibility of upper eyelid measurements. Br J Ophthalmol. 2001;85(1):99-101.
  • 12. Ogasawara K. Application of Second-Generation Swept-Source Anterior Segment-OCT in the Measurement of Marginal Reflex Distance-1 (MRD-1). Clin Ophthalmol. 2020;14:635-42.
  • 13. Rufer F, Schroder A, Erb C. White-to-white corneal diameter: normal values in healthy humans obtained with the Orbscan II topography system. Cornea. 2005;24(3):259-61.
  • 14. Kovacic Z, Ivanisevic M, Plestina-Borjan I, Capkun V. [Automatic refractometry, reliability of the determination of type and degree of refraction anomalies]. Lijec Vjesn. 1998;120(6):162-4.
  • 15. Yolcu D, Ozdogan S. A novel method to measure margin reflex distance using the autorefractometer. Int Ophthalmol. 2022;42(4):1241-7.
  • 16. Roelofs KA, Margines JB, Chen T, Goodyear K, Goldberg RA, Rootman DB. Optimizing Management of Asymmetric Ptosis: A Comparison of Three Posterior Approach Resection Algorithms. Ophthalmic Plast Reconstr Surg. 2023;39(1):72-5.
  • 17. Dan J, Sinha KR, Rootman DB. Predictors of Success Following Muller's Muscle-Conjunctival Resection. Ophthalmic Plast Reconstr Surg. 2018;34(5):483-6.
  • 18. Leung VC, Dupuis JE, Ashraf DC, Idowu OO, Massicotte E, Vagefi MR, et al. Muller Muscle Conjunctival Resection: A Multicentered Prospective Analysis of Surgical Success. Ophthalmic Plast Reconstr Surg. 2023;39(3):226-31.
  • 19. Nishihira T, Ohjimi H, Eto A. A new digital image analysis system for measuring blepharoptosis patients' upper eyelid and eyebrow positions. Ann Plast Surg. 2014;72(2):209-13
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Göz Hastalıkları
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Demet Yolcu 0000-0002-3114-0116

Fulya Yaylacioglu Tuncay 0000-0002-2088-3416

Yayımlanma Tarihi 18 Mart 2024
Gönderilme Tarihi 15 Kasım 2023
Kabul Tarihi 16 Ocak 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 46 Sayı: 2

Kaynak Göster

Vancouver Yolcu D, Yaylacioglu Tuncay F. Muller Kası Konjonktival Rezeksiyon Cerrahisi: Yeni Bir Method İle Cerrahi Sonuçların Değerlendirilmesi. Osmangazi Tıp Dergisi. 2024;46(2):183-9.


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