Efficacy of tarsoconjunctivomullerectomy in adults with acquired aponeurogenic blepharoptosis: a large single-surgeon case-series

Hrvoje Kovacic, René J. Wubbels, Dion Paridaens*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


Purpose: To evaluate the reoperation rate and symmetry after uni- or bilateral tarsoconjunctivomullerectomy (TCM) in a large, consecutive series of adult patients suffering from mild to moderate acquired aponeurogenic blepharoptosis. Methods: Patients who underwent TCM because of mild to moderate acquired aponeurogenic blepharoptosis between January 2005 and September 2016 were analysed. Main outcome was reoperation rate. Secondary outcomes were eyelid symmetry and the effects of uni- or bilateral surgery, and in unilateral cases contralateral ptosis surgery. MRD-1 (Margin to Reflex Distance) similarity within 1 mm and contour of the eyelid were used for grading eyelid symmetry. Results: We analysed the data of 243 patients, of whom 178 underwent unilateral, and 65 bilateral TCM. Previous ptosis surgery of the same eyelid had been performed (by another surgeon) in 44 patients. Reoperation was performed in four patients after unilateral (2.2%) and in 1 patient after bilateral surgery (1.5%) (p = 1.00). After unilateral surgery, contralateral ptosis surgery due to increased contralateral ptosis was performed in 16 patients (9.0%). We found no difference in reoperation rate between patients in whom ptosis surgery had been performed previously versus primary surgery (p =.22). Symmetry was good in 44%, acceptable in 44% and poor in 12% of the patients. Conclusions: After TCM, the reoperation rate was about 2% with good or acceptable eyelid symmetry in most cases. There was no difference in reoperation results between uni- and bilateral cases. However, if we include secondary ptosis surgery of the contralateral eyelid in unilateral cases, results were better after bilateral surgery.

Original languageEnglish
Pages (from-to)262-268
Number of pages7
JournalOrbit (London)
Issue number3
Early online date10 Jul 2022
Publication statusPublished - 2023

Bibliographical note

Funding Information:
The author(s) reported there is no funding associated with the work featured in this article. We thank Jessica Leenen for the artwork in Figure 1.

Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.


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