{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T07:02:20Z","timestamp":1779174140256,"version":"3.51.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>M\u00fcller muscle\u2013conjunctival resection (MMCR) is a possible treatment for some cases of ptosis. Corneal irritation or erosions are potential complications due to the use of sutures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to evaluate the efficacy and safety of sutureless MMCR as a treatment for moderate to severe ptosis, and to assess postoperative eyelid symmetry and surgical success rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective, single-center cohort study was performed. Patients with a positive response to phenylephrine 10% underwent sutureless MMCR performed by the same surgeon. Pre- and postoperative margin-reflex distance 1 (MRD1) measurements were collected at baseline, and at 1 and 8 weeks after surgery. Data were collected from the files of 147 patients (252 eyes) with moderate to severe ptosis (MRD1, 0-2\u2005mm) who underwent sutureless MMCR between October 2019 and October 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Surgical success (defined as a postoperative MRD1 of \u22653\u2005mm or \u00b10.5\u2005mm of the preoperative MRD1 after phenylephrine instillation) was achieved in 88.5% of cases, with a mean [standard deviation] MRD1 improvement of 1.61 [0.89]\u2005mm (P &amp;lt; .001). Symmetry (defined as \u22641\u2005mm difference in MRD1 between eyes) was obtained in 93.3% of bilateral cases. There was no significant difference between preoperative MRD1 after phenylephrine and postoperative MRD1 at 8 weeks (P = .54). Female patients had higher surgical success rates (odds ratio, 2.22; 95% CI, 1.01-4.95, P = .047). Complications were minimal, with wound dehiscence occurring in 1.19% of cases. Statistical analysis, including univariable and multivariable regression, was performed to assess factors associated with surgical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Sutureless MMCR demonstrated high success rates and postoperative symmetry, with low complication rates, supporting its efficacy as a reliable and minimally invasive procedure for the treatment of ptosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaf115","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T13:02:02Z","timestamp":1751029322000},"page":"1109-1114","source":"Crossref","is-referenced-by-count":1,"title":["The Wonder of Sutureless M\u00fcllerectomy"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6554-8622","authenticated-orcid":false,"given":"Maya","family":"Atar-Vardi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biana","family":"Dubinsky-Pertzov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2264-3854","authenticated-orcid":false,"given":"Shir","family":"Butnik-Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morris 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