Muller's muscle fibrosis is an independent predictive factor in the outcome of Muller's Muscle-Conjunctival Resection
Seyed Mohsen Rafizadeh1 *, Mohammad Taher Rajabi 1 , Hassan Asadi gandomani 1 , Navid Mohsenzadeh 1 , Zohreh Nozarian 2 , Mohammadreza Ghaedamini 1
- Department of Orbital and Oculoplastic Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Pathology ward, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract: The purpose of our study is to investigate the histopathology of Muller's muscle extracted after Muller's Muscle-Conjunctival Resection (MMCR) for the treatment of mild to moderate ptosis and to find the relationship between histopathological findings and the results of ptosis surgery.
Methods: Forty-seven patients with mild to moderate ptosis underwent MMCR surgery, and pathological samples including conjunctiva and Müller muscle were stained with Hematoxylin and Eosin and Masson trichrome stains. The amount and degree of muscle fibrosis, and also the presence or absence of hypertrophy in the muscle were evaluated. Clinical indicators of ptosis were recorded in the oculoplastic clinic before and after surgery. Data analysis was done with SPSS software to determine the relationship between pathology findings and surgical results.
Results: The results showed that increase in severity of fibrosis (for example, increase from mild to moderate) when the other factors are adjusted, increases the 1 mm correction effect by 0.027 mm (CI=0.002-0.052 and p-value=0.033). There is no association between the 1mm correction effect (p-value=0.67), ptosis correction (p-value=0.60), and post-operation difference between ptotic and normal eye (p-value=0.90) with Müller muscle hypertrophy. Also, there is no statistically significant association between Müller muscle hypertrophy and 1mm correction effect, ptosis correction and post-operation difference according to the type of pathogenesis (aponeurotic; p-value=0.123, congenital; p-value=0.286, horner syndrome; p-value=0.667).
Conclusion: Following the increase in Müller's muscle fibrosis, the ptosis correction effect of the MMCR surgery increases, but the presence or absence of hypertrophy of Müller's muscle is not correlated to the results of surgery.
