A droopy eyelid, also known as ptosis, is extremely common in males and females of all ages. Eyelid ptosis may affect quality of vision or create an aesthetic concern for the patient.
Eyelid ptosis repair is always surgical. The operation may be performed through a skin incision (external approach) or by using an internal approach. The internal repair is known as CMMR (conjunctivo-müllerectomy).
First, the patient is sedated and the surgical site is sterilized. Then, the eyelid is everted to mark the amount of tissue that will be resected. This amount is calculated in the surgeon’s office during the preoperative consultation. The patient must respond to phenylephrine drops to be a good candidate for CMMR.
A special instrument, called Putterman clamp, is utilized to grasp the conjunctiva and muscle. By removing these tissues, the eyelid should be shortened internally, resulting in ptosis correction.
A non-absorbable suture is then placed in a running mattress fashion below the clamp. The suture is placed across the eyelid and then turned around.
A steel blade is used to carefully cut across the tissues underneath the clamp. The whole operation is performed in about 15 minutes.
Finally, a protective contact lens is placed on the operated eye to prevent irritation from the suture. The patient goes home without a patch and is seen the next day in the office.
Eyelid appearance on the first day. It is easy to observe the symmetry in eyelid position after CMMR. The patient is pain-free, with minimal inflammation.
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