What question did this study set out to answer?

To compare the effectiveness and safety of sutureless conjunctiva-sparing Müllerectomy versus traditional Müllerectomy in pediatric ptosis repair.

March 25, 2026

Pediatric Sutureless Conjunctiva-Sparing Versus Traditional Müllerectomy: A Comparative Study

Puntos clave

To compare the effectiveness and safety of sutureless conjunctiva-sparing Müllerectomy versus traditional Müllerectomy in pediatric ptosis repair.
Retrospective comparative study design
Inclusion of pediatric patients below 18 years with mild ptosis and near-normal levator function
Comparison of outcomes including margin-reflex distance, operative time, complications, and reoperation rates
Mean ΔMRD1 was 1.2 mm in the sutureless group and 1.3 mm in the traditional group (P=0.56)
Symmetry at last follow-up was 0.7 mm for sutureless and 0.8 mm for traditional (P=0.74)
Operative time was significantly shorter for sutureless CSM (7.5 min vs 13.5 min; P=0.001)
Reoperation rates were comparable at 33% for sutureless and 18% for traditional (P=0.35)
No complications were reported in either group

Resumen

Purpose: To compare sutureless conjunctiva-sparing Müllerectomy (CSM) versus Müller muscle–conjunctival resection (MMCR) in pediatric ptosis repair. Methods: This is a retrospective comparative study of pediatric patients with mild ptosis and near-normal levator function who underwent either sutureless CSM or MMCR at a single academic institution. Children aged below 18 years with unilateral or bilateral ptosis and levator function ≥10 mm were enrolled in this study. Patients with prior ptosis repair were excluded. Primary outcomes were change in margin–reflex distance 1 (ΔMRD1) and postoperative symmetry; secondary outcomes included operative time, postoperative complications, and reoperation. Results: Thirty-three operative eyelids met the inclusion criteria: 13 underwent sutureless CSM, and 20 underwent traditional Müllerectomy. Age at surgery, preoperative MRD1, and levator function did not significantly differ between cohorts. Both cohorts were predominantly comprised of patients with congenital myogenic ptosis. Mean ΔMRD1 was 1.2 mm in the sutureless CSM group versus 1.3 mm in the MMCR group ( P =0.56), and symmetry at last follow-up was 0.7 mm versus 0.8 mm ( P =0.74). Operative time was significantly shorter for sutureless CSM (7.5 versus 13.5 min per eyelid; P =0.001). Reoperation rates (33% versus 18%; P =0.35) and complication incidence (none in both groups) were comparable. Conclusions: Sutureless CSM achieves similar eyelid elevation and symmetry to MMCR while reducing operative time, supporting its adoption as a safe and efficient alternative in pediatric ptosis repair.

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