{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:31:48Z","timestamp":1771504308281,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,8,25]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate postoperative changes in corneal topographic parameters and higher-order aberrations (HOAs) following M\u00fcller muscle-conjunctival resection (MMCR) in patients with mild-to-moderate ptosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective clinical study included patients who underwent MMCR after a positive phenylephrine test and with good levator function who were evaluated. Preoperative and postoperative best-corrected visual acuity (BCVA), margin reflex distance 1 and corneal parameters (flat meridian, steep meridian, simulated keratometry, maximum keratometry), along with HOAs including coma, trefoil, spherical aberration, secondary astigmatism and quadrifoil, were assessed at week 1, month 1 and month 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 50 eyes from 50 patients were included in the study. BCVA showed mild deterioration at week 1 but returned to baseline by month 3. At postoperative week 1, lagophthalmos was observed in 12% and superficial punctate keratopathy (SPK) in 14% of eyes; both resolved completely by month 1. Eyes with SPK showed significantly greater changes in trefoil compared with those without (p=0.01\u2009and p=0.03 for 4\u2009mm and 6\u2009mm pupil diameters, respectively). A significant difference was found between preoperative and postoperative coma (p=0.04) and secondary astigmatism (p=0.03) values; however, these parameters returned to baseline levels by the third month postoperatively. Surgical success was achieved in 92% of cases. Undercorrection was seen in 6% and overcorrection in 2%, with no functional or cosmetic issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MMCR may cause corneal topographic changes during the early postoperative period. However, these changes appear transient, and MMCR remains a visually safe and refractively stable surgical option for suitable ptosis patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327822","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T17:20:44Z","timestamp":1757352044000},"page":"262-267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Refractive changes and higher-order aberrations after M\u00fcller muscle conjunctival resection: a prospective clinical study"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5348-9829","authenticated-orcid":false,"given":"Metehan","family":"Simsek","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ministry of Health Dogubayazit Dr Yasar Eryilmaz State Hospital, Agri, Agri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilker","family":"Hosver","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Goksel","family":"Ulas","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayse","family":"Cetin Efe","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma","family":"Poslu Karademir","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selvihan","family":"Sagdic Ozcelik","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Diri","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhittin","family":"Taskapili","sequence":"additional","affiliation":[{"name":"Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"2026021903500776000_110.3.262.1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/IOP.0000000000002746","article-title":"The Utility of Preoperative Phenylephrine Testing in M\u00fcller Muscle Conjunctival Resection Surgery for Involutional Ptosis","volume":"41","author":"Saffari","year":"2025","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"2026021903500776000_110.3.262.2","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.9.6.413"},{"key":"2026021903500776000_110.3.262.3","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2022.743543","article-title":"Evaluation of Disk Halo Size and Identification of Correlated Factors in Myopic Adults","volume":"9","author":"Zhao","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"2026021903500776000_110.3.262.4","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.2147\/OPTH.S21819","article-title":"Correlation between contrast sensitivity and higher-order aberration based on pupil diameter after cataract surgery","volume":"5","author":"Yamaguchi","year":"2011","journal-title":"Clin Ophthalmol"},{"key":"2026021903500776000_110.3.262.5","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.clae.2018.05.001","article-title":"Corneal topography with an aberrometry-topography system","volume":"41","author":"M\u00fclhaupt","year":"2018","journal-title":"Cont Lens Anterior Eye"},{"key":"2026021903500776000_110.3.262.6","doi-asserted-by":"crossref","DOI":"10.3390\/diagnostics11081466","article-title":"Current Developments in Corneal Topography and Tomography","volume":"11","author":"Kanclerz","year":"2021","journal-title":"Diagnostics (Basel)"},{"key":"2026021903500776000_110.3.262.7","unstructured":"Tabachnick BG , Fidell LS . 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