改良膨体聚四氟乙烯额肌悬吊术治疗先天性上睑下垂的临床研究  

Clinical study of modified polytetrafluoroethylene frontal muscle suspension for congenital ptosis

作　　者：苏娱 李义宝 王涛 孙慧慧 张诚玥[2] Su Yu;Li Yi-bao;Wang Tao(Department of Ophthalmology,Anhui childrens Hospital,Hefei 230051,China)

机构地区：[1]合肥安徽省儿童医院院眼科,230051 [2]首都医科大学附属北京儿童医院眼科儿科学国家重点学科国家儿童医学中心

出　　处：《中国斜视与小儿眼科杂志》2020年第4期25-28,9,I0014,共6页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的探究改良膨体聚四氟乙烯(e-PTFE)材料额肌悬吊术与慕丝线额肌悬吊术治疗先天性上睑下垂的效果及安全性。方法选取我院眼科收治的24例改良e-PTFE补片额肌悬吊术治疗的上睑下垂患儿为观察组,25例3-0慕丝线治疗的上睑下垂患儿作为对照组。比较两组患儿手术前后睑缘角膜映光距离(MRD)、睑裂高度、眼睑闭合度以及眼表形态变化情况,比较两种手术方法的眼睑闭合时间、美容效果以及并发症发生情况。结果两组患儿术后1月、6月MRD和睑裂高度与术前比较均得到显著提高(P<0.01),而眼睑闭合度与术前比较均无明显改变,组间三项指标比较也无显著差异(P>0.05)。两组患儿术后1月泪膜破裂时间分别为8.02±2.15s、8.12±2.25s,差异无统计学意义(P>0.05),而术后6个月观察组患儿泪膜破裂时间为8.18±2.20s,明显高于对照组5.24±1.39s,差异有统计学意义(P=0.00)。观察组患儿术后角膜荧光素染色评分、眼睑闭合时间均明显低于对照组,差异有统计学意义(P<0.05)。两组患儿术后美容效果评分明显高于术前,且观察组明显高于对照组(P<0.05)。观察组并发症总发生率为8.33%,明显低于对照组56.00%,差异有统计学意义(P=0.00)。结论e-PTFE额肌悬吊联合个体化重睑术治疗儿童上睑下垂疗效和美容效果显著。Objective To explore the clinical efficacy and safety of modified expanded polytetrafluoroethylene(ePTFE)material frontalis muscle suspension and MERSILK suture frontalis muscle suspension in children with congenital ptosis.Methods A retrospective analysis was designed to select 25 children with ptosis who were treated in our ophthalmology department as the control group,and 24 cases as the observation group.3-0 MERSILK suture and e-PTFE patch were used respectively to suspend the frontal muscles.The preoperative and postoperative margin reflection distance(MRD),palpebral fissure height,eyelid closure situation and ocular surface morphology were compared between the two groups.The eyelid closure time,cosmetic effect and complications of the two surgical methods were compared.Results The MRD and palpebral fissure heights of the two groups were significantly improved at 1 and 6 months after operation.The difference was statistically significant(P<0.01),but the eyelid closure situation was not significantly different from that before surgery.There were no significant difference in MRD,palpebral fissure height and eyelid closure situation comparison between the two groups(P>0.05).The tear film break-up time at 1 month after operation of the two groups was 8.02±2.15 s and8.12±2.25 s respectively,and there was no significant difference between the two groups(P>0.05).The tear film break-up time of the observation group at 6 month after operation(8.18±2.20 s)was longer than the control group at the same time(5.24±1.39 s),and the difference was statistically significant(P=0.00).The postoperative corneal fluorescein staining score and eyelid closure time were significantly lower in the observation group than in the control group,with statistically significant.The scores of the postoperative cosmetic effects of the two groups were significantly higher than before surgery.And the observation group was significantly higher than the control group(P<0.05).The total incidence of complications in the observation group was 8.3

关 键 词：膨体聚四氟乙烯 上睑下垂 额肌悬吊术 重睑术 

分 类 号：R779.6[医药卫生—眼科]