改良式额肌腱膜瓣悬吊术矫正儿童重度先天性上睑下垂  

Clinical observation of modified frontalis tendon flap suspension in the treatment of severe congenital blepharoptosis in children

作　　者：郭燕[1] 陶利娟[1] 杨俊芳[1] 向剑波[1] 何容[1] 唐璟[1] Yan Guo;Li-Juan Tao;Jun-Fang Yang;Jian-Bo Xiang;Rong He;Jing Tang(Department of Ophthalmology, Hunan Children’s Hospital;Children’s Prevention and Treatment Center for Strabismus,Amblyopia and Optometry of Hunan,Changsha 410007, Hunan Province, China)

机构地区：[1]湖南省儿童医院眼科,湖南省儿童斜弱视眼视光防治中心,中国湖南省长沙市410007

出　　处：《国际眼科杂志》2018年第1期182-184,共3页International Eye Science

基　　金：湖南省科学技术厅科技计划资助项目(No.2014WK2033)

摘　　要：目的:探讨改良式额肌腱膜瓣悬吊术矫治儿童重度上睑下垂的长期临床疗效。方法:回顾性分析2009-01/2011-12在我科收治的儿童重度上睑下垂患者83例114眼,采用改良式扇形额肌腱膜瓣悬吊术进行矫治,分析术后上睑下垂矫正效果和上睑缘弧度、重睑形成及倒睫、结膜脱垂等并发症发生情况。随访观察5a。结果:术后第5a,矫正满意和基本矫正者共有84眼(73.7%),部分矫正30眼(26.3%),手术效果满意。术后并发症包括倒睫4眼(3.5%),其中3例3眼上睑内侧1/3灰线处缝牵引缝线牵引1wk后消失,1例1眼行二次手术;结膜脱垂2眼(1.8%),应用皮质类固醇激素眼药水点眼,加压包扎1wk后结膜脱垂均消失;术后无1例发生暴露性角膜炎、眼睑外翻、睑球分离、眼睑成角畸形、血肿形成、感染等并发症。术后上睑回退和外侧重睑皱襞消失是长期随访最常见的问题。结论:改良式额肌腱膜瓣悬吊术矫治儿童重度上睑下垂长期疗效满意,效果持久稳定,安全可靠。AIM:To investigate the long-term clinical effect of modified frontalis tendon flap suspension in the treatment of severe blepharoptosis in children.METHODS:A total of83cases(114eyes)of modified frontalis tendon flap suspension for children severe blepharoptosis correction were analyzed between January2009to December2011for the efficacy and complications of this surgery.Follow-up observation for5a.RESULTS:In the fifth year after operation,there were84eyes(73.7%)with correction and satisfactory correction,30eyes(26.3%)were corrected,and the operation was satisfactory.Postoperative complications included4eyes(3.5%)of inverted eyelashes,of which3eyes were given suture traction at1/3interior of the gray line,1wk later inverted eyelashes disappeared,1eye of secondary surgery.Conjunctival prolapse was in2eyes(1.8%),the application of corticosteroids eye drops.pressure bandage were used for1wk and conjunctival prolapse disappeared.There was no recurrence of keratitis,eyelid ectropion,septum separation,eyelid angular deformity,hematoma formation,infection and other complications.Postoperative retrograde retrogression and lateral eyelid folds disappear were the most common problems of long-term follow-up.CONCLUSION:The study shows that this surgical technique is a satisfied method to treat severe blepharoptosis and predictable with few complications.

关 键 词：上睑下垂 额肌腱膜瓣悬吊术 长期随访 

分 类 号：R779.6[医药卫生—眼科]