儿童动眼神经麻痹所致上睑下垂膨体聚四氟乙烯额肌悬吊术的治疗效果  

Efficacy of frontalis suspension using e-PTFE for pediatric ptosis due to oculomotor nerve palsy

作　　者：曹文红[1] 吴倩[1] 樊云葳[1] 王媛[1] 于刚[1] 

机构地区：[1]首都医科大学附属北京儿童医院眼科儿科学国家重点实验室国家儿童医学中心,北京100045

出　　处：《中华眼外伤职业眼病杂志》2017年第9期653-657,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 探讨膨体聚四氟乙烯（e-PTFE）材料额肌悬吊术治疗儿童动眼神经麻痹所致上睑下垂的效果.方法 儿童动眼神经麻痹所致上睑下垂5例（5只眼）,年龄2岁6个月～7岁9个月,均为重度上睑下垂、眼球运动受限、弱视及Bell现象阴性.2例伴有外下斜视,先行垂直斜视矫正术,术后6～12个月二期行上睑下垂矫正术,3例伴有外斜视,一期即行上睑下垂矫正术.结果 5例（5只眼）术后1周上睑缘平齐角膜上缘,术后6～18个月,3例上睑缘与角膜光反射间距离（MRD）为2.5 mm,属于优秀,2例MRD为1.5～2 mm,属于良好.睑缘弧度满意,无眼睑内外翻或暴露性角膜炎等并发症.结论 使用e-PTFE材料行额肌悬吊术治疗儿童动眼神经麻痹所致上睑下垂取得初步满意的手术效果,该术式具有并发症少、局部反应轻及恢复快的优势.Objective To investigate the efficacy of frontalis suspension using expanded polytetrafluoroethylene（e-PTFE）as sling materials for pediatric ptosis due to oculomotor nerve palsy.Methods Five eyes of 5 children with ptosis due to oculomotor nerve palsy were analyzed retrospectively.They were 2.5-7.8 years old,manifested as complete ptosis,Bell＇s phenomenon（-）,extraocular muscle paralysis and amblyopia.Two cases with exocatatropia were treated with strabismus surgery first and the ptosis suspension was performed 6-12 months after surgery,other 3 cases with exotropia were treated with correction of blepharoptosis.Results One week after surgery,upper eyelids margin were located on the superior cornea limbal in 5 eyes of 5 cases.Three eyes of upper eyelids margin reflex distances（MRD）were excellent（2.5 mm）,the other 2 eyes of MRD were good（1.5-2.0 mm）6-18 months after surgery.No postoperative exposure keratitis,entropion or ectropion occurred.Conclusion Frontalis suspension using e-PTFE for pediatric ptosis due to oculomotor nerve palsy is a safe and effective surgical method.The surgery has the advantages including less complications and faster postoperative recovery.

关 键 词：上睑下垂 动眼神经麻痹性 儿童 悬吊术 膨体聚四氟乙烯(e-PTFE) 

分 类 号：R779.6[医药卫生—眼科]