Location of the vascular arcade superficial and deep to the muller muscle related to blepharoptosis surgery

The aim of this study is to elucidate the location of the vascular arcades of the Muller muscle as it is related to blepharoptosis surgery.A total of 28 eyelids of 14 patients were observed. In 4 hemifaces of 2 fresh Korean adult cadavers, injection of red latex and dissection were performed via a cutaneous and conjunctival approach. Measurements were performed for determination of distances from the upper margin of the tarsal plate to the visible vascular arcades.Two parallel vascular arcades were observed through the conjunctiva. The distance from the upper margin of the tarsal plate to the visible vascular arcade was 6.86 T 0.53 mm (lower arcade) and 11.71 T 0.73 mm (upper arcade), respectively. Using the skin approach, an upper vascular arcade was observed between the levator aponeurosis and the Muller muscle. Using the conjunctival approach, a lower vascular arcade was observed between the conjunctival epithelium and the Muller muscle. We hope that these two vascular arcades can be regarded as landmarks for placating the Muller muscle in blepharoptosis surgery.