Müller muscle conjunctival resection 2
This video demonstrates a Müller muscle-conjunctival resection. A 4-0 Silk suture is placed through the upper eyelid margin at the level of the gray line. The eyelid is then everted over a Desmarres retractor. The central third of the tarsus is then marked with the monopolar cautery. An 8.5 resection will be performed in this case, so the calipers are placed at 4.25 mm and the resection is marked with the monopolar cautery. Paufique forceps then grasp the conjunctiva and the Putterman clamp is placed at the superior border of the tarsus and tightened. Additional topical anesthetic is applied. A 6-0 chromic suture is then placed in a running mattress fashion. This can be stated medially or laterally, usually I would prefer to start the suture laterally. In this case, the suture was started medially. The suture is placed in one direction and the turned around to be placed in the opposite direction. A 15 blade is then used to excise the conjunctiva and Muller muscle. This should have a metal on metal feel to avoid cutting the suture. The suture is then tied, and a contact lens is placed to protect the eye from an irritation from the sutures. Topical antibiotic is then placed on the eye. The 4-0 suture is the removed.