{'fraction_non_alphanumeric': 0.022711631108052306, 'fraction_numerical': 0.012388162422573986, 'mean_word_length': 5.187234042553191, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Risk of dry eye after mullerectomy via the posterior conjunctival approach for thyroid-related upper eyelid retraction

INTRODUCTION : Mullerectomy by a conjunctival approach is an excellent way to reduce thyroid-related superior lid retraction. Especially the lateral horn of the levator, into the lacrimal gland, has to be reduced. Alterations in lacrimal secretion have been hypothesized, but never studied. MATERIALS AND METHODS : The basal and reflex Schirmer test and functional status were studied in 39 patients with thyroid-related orbitopathy after mullerectomy by a conjunctival approach (12 functional, 27 cosmetic indications). In 24 patients, the results could be compared with those of other measures carried out pre- or postoperatively or, in case of unilateral surgery, the operated and non-operated sides were compared. RESULTS : The Schirmer test was reduced in 7 of 12 functional cases and in 4 of 27 cosmetic cases. Although tear production was reduced, only two patients had to have increased dosages of artificial tears and two other patients required punctum plugs. Among the 12 functional indications, 10 showed an improved corneal surface. CONCLUSION : Lacrimal production may be reduced after mullerectomy by the conjunctival approach. Nevertheless, the clinical risk is low in comparison with the functional and cosmetic results of the procedure. At present, we try to identify and preserve the lacrimal ostia during surgery.