Müller's muscle resection

The upper eyelid retracted as a widening of the eye crack, and the upper sclera was partially exposed. When the eyeball was looking down, the upper eyelid could not move downward with the eyeball and moved downward, showing hysteresis. It is one of the most common eye diseases of Graves' eye disease. Most of the patients with hyperthyroidism are affected by both eyes. Most of the normal thyroid function is monocular. Treatment of diseases: congenital eyelid defects Indication Müller myotomy is available for: 1. The thyroid function test is normal before surgery can be considered. 2. The upper eyelid retracts to expose the cornea, epithelial erosion or corneal infiltration. 3. Hyperthyroidism or Graves' eye disease has been stabilized for more than half a year. 4. One side of the upper jaw retraction, splitting and widening to form a defect in appearance. Surgical procedure 1.0.5% tetracaine topical anesthesia. The subconjunctival injection of 2% lidocaine + 0.5% bupivacaine 1:2 mixture 0.5 ml. Excessive amount of anesthetic can cause the ptosis to sag, and it is difficult to judge whether the amount of surgical resection is appropriate. 2. Pull the suture with the gingival margin and flip the upper eyelid with the eye hook. 3. Make a vertical incision 10 mm outside the upper conjunctiva and separate it between the conjunctiva and the Müller muscle with an iris restorer. 4. The medial conjunctiva also made a vertical incision of 10 mm long, and the conjunctiva was cut along the upper edge of the iliac crest, and the conjunctival flap was turned upside down to expose the back of the Müller muscle. 5. Locate the lateral edge of the Müller muscle and separate it between the Müller muscle and the aponeurosis of the diaphragm with an iris restorer. Peel off to the upper edge of the iliac crest 10 mm and pierce from the inner edge of the Müller muscle. 6. Cut the Müller muscle at the edge of the tarsal plate, and then cut off the Müller muscle 10 mm from the sacral margin. 7. Let the patient sit up and see if the upper eyelid still has a retraction and whether the bilateral eye cracks are symmetrical. If the sensation is insufficient, the aponeurosis of the diaphragm is lifted on the cut portion of the middle part of the humeral plate to the symmetry of both sides. 8. The conjunctival horizontal incision was sutured continuously with 7-0 silk.