@article {416856,
	title = {Mullers Muscle Conjunctival Resection for Treatment of Contact Lens-Associated Ptosis.},
	journal = {Ophthal Plast Reconstr Surg},
	volume = {32},
	number = {4},
	year = {2016},
	month = {2016 Jul-Aug},
	pages = {257-60},
	abstract = {PURPOSE: The aim of this study was to look at the surgical outcomes of posterior approach Mullers muscle conjunctival resection surgery for contact lens-related ptosis. METHODS: This was a retrospective, comparative interventional case series. All patients and controls underwent phenylephrine 10\% testing and had a positive response prior to surgical intervention. RESULTS: Thirty-one eyelids with ptosis were identified in 20 contact lens wearing patients, which were matched with 27 eyelids in 15 controls. The contact lens wearing patients wore contact lenses for a mean of 20.6 {\textpm} 12.1 years. More than half (60\%) wore soft contact lenses, as opposed to rigid gas-permeable contact lenses. Preoperative margin-to-reflex distance-1 was lower in patients who wore rigid contact lenses (0.8 {\textpm} 0.7 mm) as compared with patients with soft contact lenses (1.7 {\textpm} 1.1 mm) (p = 0.01). Surgical success, as defined by margin-to-reflex distance-1 >=3 mm or symmetry of upper eyelid height (within 1 mm), was achieved in 93.5\% in the contact lens group and 92.6\% of controls. Postoperative margin-to-reflex distance-1 was significantly higher in the contact lens wearers (3.9 {\textpm} 1.3 mm) compared with the controls (3.2 {\textpm} 1.1 mm; p = 0.01). There was a significant correlation between the amount of tissue resected intraoperatively and the improvement in margin-to-reflex distance-1 (Pearsons correlation coefficient, r =0.36; p = 0.006). There were no surgical complications of any patients in the study. CONCLUSION: Mullers muscle conjunctival resection surgery is an effective surgical correction for contact lens-associated ptosis. Patients can achieve excellent results with minimal risk of residual ptosis or asymmetry.},
	issn = {1537-2677},
	doi = {10.1097/IOP.0000000000000479},
	author = {Teo, Livia and Lagler, Christine P and Mannor, Geva and Glass, Lora D and Freitag, Suzanne K}
}
