Muller's muscle conjunctival resection versus external levator advancement for ptosis repair: systematic review and meta-analysis.
Author
Karam, MohammadAlsaif, Abdulmalik
Abul, Ahmad
Alkhabbaz, Ali
Alotaibi, Abdulaziz
Shareef, Eiman
Behbehani, Raed
Affiliation
Ibn Sina Hospital; University of Leeds; Walsall Healthcare NHS Trust; Kuwait UniversityPublication date
2023-01-24
Metadata
Show full item recordAbstract
Purpose: To compare the outcome of Muller's muscle conjunctival resection (MMCR) versus external levator advancement (ELA) in patients undergoing ptosis surgery. Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and a search of electronic information was conducted to identify all comparative studies of MMCR versus ELA in ptosis repair. The primary outcome measures were the post-operative marginal reflex distance (MRD1), ptosis under-correction, over-correction, and re-operation rate. Secondary outcome measures included cosmetic appearance, complications, operative time, and learning curve. Fixed-effect modelling was used for the analysis. Results: Seven studies that enrolled 1038 eyelids were identified in the literature. There was no statistically significant difference between the MMCR and ELA groups in post-operative MRD1 (Mean Difference [MD] = 0.13, P = 0.28) and the rate of under-correction odds ratio [OR] = 0.49, P = 0.14). However, ELA had a significantly higher rate of over-correction (OR = 0.17, P = 0.04) and re-operations (OR = 0.26, P = 0.0001) compared to MMCR. For secondary outcomes, MMCR had an improved cosmetic appearance, lower total number of complications and shorter operation time (MD = - 10.96, P < 0.00001). Finally, the two techniques had no significant difference in the learning curves. Conclusion: Both MMCR and ELA are effective techniques for the surgical correction of ptosis; however, MMCR surgery is a more predictable and robust technique compared to, ELA with lower rates of over-correction and re-operation.Citation
Karam M, Alsaif A, Abul A, Alkhabbaz A, Alotaibi A, Shareef E, Behbehani R. Muller's muscle conjunctival resection versus external levator advancement for ptosis repair: systematic review and meta-analysis. Int Ophthalmol. 2023 Jul;43(7):2563-2573Type
ArticlePMID
36692699Journal
International OphthalmologyPublisher
Springerae974a485f413a2113503eed53cd6c53
10.1007/s10792-023-02633-1