提上睑肌缩短联合翼状韧带悬吊改善重度先天性上睑下垂提上睑肌功能  

Levator resection with check ligament suspension improve levator function in patients with severe congenital ptosis

作　　者：田青 牛贺平 刘凡菲 潘桔昕 王星星[2] 陈文生[2] 

机构地区：[1]河南省南阳市眼科医院,473014 [2]厦门大学眼科研究所及厦门大学眼科中心,361005

出　　处：《中国实用眼科杂志》2016年第7期750-753,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨提上睑肌缩短联合翼状韧带悬吊治疗先天性重度上睑下垂远期美容效果，并分析该手术方法引起的提上睑肌功能的变化。方法对自2012年3月至2015年1月接受提上睑肌缩短联合翼状韧带悬吊治疗先天性重度上睑下垂患者60例（90只眼）进行回顾性分析。患者的随访时间为9～15月（平均12月）。评估术前和术后瞳孔中心至上睑缘中点的距离，提上睑肌功能，及术后美容效果和并发症。结果46例术后美容效果评分为优，14例患者美容效果评分为良，无严重并发症发生。术前平均瞳孔中心至上睑缘中点的距离为（-0．12±0．11）mm，最后随访时平均瞳孔中心至上睑缘中点的距离为（4．4±0．32）mm。统计分析结果显示，术前和最后随访平均瞳孔中心至上睑缘中点的距离差异有统计学意义（P〈0．01）。平均术前提上睑肌肌力为（2．1±0．17）mm，在最后随访时提上睑肌肌力增至（6．2±0．28）mm，差异有统计学意义（P〈0．005）。结论提上睑肌缩短联合翼状韧带悬吊治疗重度先天性上睑下垂，不仅能获得良好的治疗效果，而且能导致术后提上睑肌功能有实质性的改善。Objective To evaluate long-term cosmetic outcomes and to assess the change in levatot function （LF） in patients with severe congenital ptosis who underwent levator resection with check ligament suspension. Methods The medical records of 60 patients （90 eyelids） with severe congenital ptosis who underwent levator resection with check ligament suspension between March 2012 and January 2015 were retrospectively reviewed. The follow-up time ranged from 9 to 15 months （median, 12 months）. Data regarding preoperative and postoperative margin-reflex distance 1 （MRD-1） and LF, and postoperative cosmetic outcomes and complications were evaluated. Results Excellent cosmetic results occurred in 46 patients, good cosmetic results occurred in 14 patients and no postoperative complications occurred. The average preoperative MRD-1 measured-0.12±0.11 mm. The average postoperative MRD-1 measured 4.4±0.32 mm at last follow-up visit. There was a statistically significant difference between preoperative and postoperative MRD-1 values （P 〈0.001）. The mean preoperatively LF was 2.1±0.17 mm, which was increased postoperatively to 6.2±0.28 mm at the final visit （P 〈0.005）. Conclusions The levator resection with check ligament suspension, which is an effective treatment for severe congenital ptosis, results in substantial improvement of postopera- tive LF.

关 键 词：提上睑肌缩短 翼状韧带悬吊 提上睑肌功能 重度先天性上睑下垂 美容效果 

分 类 号：R777.1[医药卫生—眼科]