THE RESULTS OF SURGICAL TREATMENT OF PTOSIS OF THE UPPER EYELID, ASSOCIATED WITH FATTY DEGENERATION OF THE MÜLLER MUSCLE OF THE UPPER EYELID
Objective: to evaluate the results of surgical treatment of ptosis of the upper eyelid caused by a poorly understood cause fatty infiltration of the muscle of Müller of the upper eyelid, confirmed by histopathological method. Materials and methods. The study included 18 patients (18 eyes) with acquired upper eyelid ptosis due to adipose dystrophy of the Müller’s muscle of varying severity. At the preoperative stage, the basic parameters were determined: MRD1, the width of the eye slit, the symmetry of the upper orbitopalpebral fold. Transcutaneous access resection with conjunctival Müller muscle 6-8 mm. For histopathological studies the fragments of the “muscle of Müller-conjunctiva” stained by hematoxylin and eosin, methods of Van-Gieson and of Mallory. Three bioptates of the «muscle of Müller-conjunctiva» complex with unchanged Müller muscle acted as control samples. The percentage of fat and muscle tissue are calculated using morphometric mesh Avtandilov. Statistical analysis: Statistica software, version 10.0. Results. Intraoperatively at the stage of visualization of the complex “Тhe aponeurosis of the levator-muscle of Müller- conjunctiva” was defined dramatic thinning of the levator aponeurosis and thickening layers of tissue in the course of square Müller muscle. Microscopy revealed the morphological pattern of substitution partial fatty degeneration of the smooth muscle tissue. Postoperative MRD1 all patients achieved from +2.5 to +4 mm. The position of the century and remained stable during the whole observation period (11 months). Conclusion. The «muscle of Müller resection of the upper eyelid transcutaneous access to the underlying conjunctiva with ptosis, due to fatty degeneration of the muscle of Müller, giving a stable positive clinical result. The described cause of acquired ptosis is insufficiently studied and requires a differentiated approach to surgical treatment (3 figs, 1 table, bibliography: 10 refs).