Eyelid: Conjunctival Müller’s Muscle Resection (CMMR)

In patients presenting with ptosis, a complete exam, including eyelid measurements before and after instillation of 2.5 % phenylephrine, is integral in determining the optimal surgical procedure. Muller’s muscle is a sympathetically innervated smooth muscle capable of elevating the upper eyelid 2–3 mm under certain physiological conditions. Instillation of phenylephrine drops in the superior fornix will stimulate Muller’s muscle in many patients; those with mild to moderate ptosis who respond following instillation of phenylephrine may be suitable candidates for a conjunctival Muller’s muscle resection (CMMR). Patients should be educated about the risks and benefits of the procedure, including alternatives.