J4 ›› 2016, Vol. 1 ›› Issue (4): 60-63.

• 临床医学 • 上一篇    下一篇

87例先天性上睑下垂手术矫正临床分析

  

  1. (大理大学玉溪教学医院,云南玉溪653100)
  • 收稿日期:2015-09-22 出版日期:2016-04-15 发布日期:2016-04-15
  • 作者简介:赵惠琼,副主任医师,主要从事临床眼科研究.

Clinical Analysis of 87 Cases of Surgical Correction of Congenital Blepharoptosis

  1. (Yuxi Teaching Hospital of Dali University, Yuxi, Yunnan 653100, China)
  • Received:2015-09-22 Online:2016-04-15 Published:2016-04-15

摘要:

目的:比较提上睑肌缩短+前徙术、额肌瓣悬吊术对先天性上睑下垂的矫正效果。方法:采取单纯重睑切口,对87例患
者中的54例共66眼行提上睑肌缩短+前徙术,33例共43眼行额肌瓣悬吊术,术后1、6、12月各随访1次,记录视力,术眼上睑缘
位置、双眼睑裂对称性,睑裂闭合不全程度、有无倒睫、成角畸形。结果:79例患者经1次手术矫正满意,6例患者矫正良好,2
例患者第一次手术矫正不足,再次手术矫正满意,无矫正过度及无效病例。结论:两种手术方法效果肯定,提上睑肌缩短术符
合生理解剖位置,术后睑裂闭合不全程度较轻并可逐渐消失,大部分患者可以选择,但是少数患者欠矫。额肌瓣悬吊术后睑裂
闭合不全程度较重,且永久存在,少部分患者出现出血、伤口裂开等并发症,但是只要术后观察护理得当,可避免并发症发生。

关键词: 先天性, 上睑下垂, 提上睑肌缩短术, 额肌瓣悬吊术

Abstract:

Objective: To compare the corrective effects of shortening and advancement of levator palpebrae superioris muscle and
frontal muscle flap suspension surgery for congenital blepharoptosis. Methods: Frontal muscle flap suspension surgery was adopted on
43 eyes of 33 patients and shortening and advancement of levator palpebrae superioris muscle was used on 66 eyes of 54 patients
among 87 cases by pure double eyelid incision. Follow-up visits of each patient were paid in the first, the sixth, the twelfth month after
the surgery for taking records of visual acuity, position of upper eyelid skin edge of the surgery eye, the symmetry of both eyes'
palpebral fissure, the level of palpebral fissure dysraphism, and any trichiasis and angulation deformity. Results: 79 patients got
satisfying effects and 6 patients got fine effects after the first surgery. 2 patients got insufficient correction after the first surgery and
then got satisfying effects by the second time. There is no overcorrection and nullity. Conclusion: Both of the operation methods had
positive effects. Shortening and advancement of levator palpebrae superioris muscle fits for physiology, and the level of palpebral
fissure dysraphism after the surgery was rather low and could disappear gradually. Most of the patients could choose this method but
few patients got insufficient correction. Frontal muscle flap suspension surgery has a serious level of palpebral fissure dysraphism after
the surgery and it could exist permanently. A few patients has complication of bleeding and wound dehiscence, which could be
prevented from happening with proper postoperative observation and nursing.

Key words: congenital, blepharoptosis, shortening levator palpebrae superioris surgery, frontal muscle flap suspension surgery

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