改良额肌瓣悬吊术治疗13例中重度下颌瞬目综合征  

Effect of modified frontalis muscle flap suspension surgery on marcus Gunn Jaw-winking syndrome

作　　者：朱晓伟 张嘉莹 丁侠[1] 李瑾[1] Zhu Xiaowei;Zhang Jiaying;Ding Xia;Li Jin(Department of Ophthalmology,Shanghai Ninth People's Hospital,Shanghai Jiao-tong University School of Medicine,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院眼科上海市眼眶病眼肿瘤重点实验室

出　　处：《临床眼科杂志》2019年第3期252-256,共5页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金面上项目(81870688);上海市科委自然基金(16ZR1419600)

摘　　要：目的探讨改良额肌瓣悬吊术治疗下颌瞬目综合征的临床疗效。方法回顾就诊于上海交通大学医学院附属第九人民医院眼科的下颌瞬目综合征患者,收集经改良额肌瓣悬吊术治疗的13例(13只眼)患者的病史资料,13例患者术前经上睑下垂及颌动瞬目现象严重程度进行分级,均表现为中重度,经同一术者手术治疗后对13例患者进行治疗效果及并发症观察。结果本组患者疗效良好,术后随访时间为(26.31±18.67)个月(范围:8-63个月);双眼睑缘高度基本一致,睑缘弧度自然,无畸形;颌动瞬目现象基本解除[术前(4.46±1.45)mm至术后(0.92±0.76) mm],睑缘角膜映光1(MRD1)由术前(-0.31±1.11)mm提高至(4.23±1.01)mm,最佳矫正视力(BCVA)由0.43±0.22提高至0.74±0.28。结论该术式较好地矫正了颌动瞬目现象,同时可获得稳定的眼睑高度;患者术后视力获得显著提升;无严重并发症,是用于矫正中重度下颌瞬目综合征安全有效的手术方式。Objective To investigate the clinical effect of modified frontalis muscle flap suspension surgery on Marcus Gunn jaw winking syndrome(MGJWS). Methods Data of 13 patients(13 eyes) with MGJWS who underwent modified frontal muscle flap suspension surgery in the Department of Ophthalmology of the Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine were reviewed. All patients presented with moderate to severe MGJWS and blephroptosis before the surgery. Treatment effect and surgical complications were assessed for all patients after the surgery which was performed by the same surgeon. Results Good clinical effect was observed for all patients. Patients were followed up for 26.31 ± 18.67 months(range: 8~63 months). The bilateral eyelids palpebral fissure were basically the same, the curvature of eyelid was natural and without deformity. The MGJWS improved from 4.46±1.45 mm before the surgery to 0.92±0.76 mm after the surgery. The MRD1 improved from-0.31±1.11 mm before the surgery to 4.23±1.01 mm after the surgery. Similarly, the best corrected visual acuity significantly improved from 0.43±0.22 to 0.74±0.28. Conclusions The modified surgical method can effectively correct the MGJWS, achieve stable eyelid height, significantly improve post-surgical visual acuity and without severe complications, thus is an effective and safe treatment option for patients with moderate to severe MGJWS.

关 键 词：下颌瞬目综合征 上睑下垂 额肌瓣悬吊术 

分 类 号：R779.6[医药卫生—眼科]