Ptosis repair is one of the most common eyelid procedures, especially amongst oculoplastic surgeons.
There are many approaches to the repair, including a levator advancement, levator resection, frontalis suspension, and a conjunctival-mullerectomy. The surgical decision is based on clinical characteristics, surgeon experience, and in part, on available instrumentation.
Before performing a conjunctival-mullerectomy, it is ideal if the patient shows response to a sympathomimetic drop applied during the pre-operative clinic evaluation. This positive response indicates that resection of the conjunctiva and Mullers muscle will yield a nice result. Next, proper instrumentation is essential in this type of ptosis repair, particularly the ptosis clamp.
The Lee-Erickson ptosis clamp from Bausch + Lomb is designed for use in conjunctival-mullerectomies. Traditionally, the Putterman clamp has been used for this procedure and is very useful. But a disadvantage I have experienced in the operating room—one which prompted me to make some revisions—was the clamp’s straight edge, making engagement of the medial and lateral tissues suboptimal.
The newly designed Lee-Erickson clamp has a rounded edge to match the curvature of the natural tarsus. This aids in a uniform purchase of the tissue across the horizontal length of the eyelid, as seen in the photo below. Like the Putterman Clamp, this clamp has tines that can be positioned at a preplaced marking suture. As the two arms are squeezed together, the tines prevent slippage of the tissues and allow for an even grasp of the conjunctiva and Mullers muscle. The sutures are run easily beneath the clamp no matter what size needle you are using, and the #15 blade passes without problem. The locking mechanism is smooth and reliable and the design is delicate, yet sturdy and durable.
This clamp was created with the incredible help of the engineers and surgical team at Storz. The company will begin commercialization of the instrument soon, but until then, the clamp can be ordered under the SP7 #70746.