提上睑肌腱膜前徙术矫正双眼轻度先天性上睑下垂的临床特征分析  

Analysis of clinical features on correction of mild congenital ptosis in both eyes by anterior displacement of the levator palpebrae muscle aponeurosis

作　　者：刘俊秀[1,2] 狄婕 朱金燕 朴俊峰 李倩 安宁宇 齐向前 杨伟 LIU Junxiu;DI Jie;ZHU JinYan;PU Junfeng;LI Qian;AN Ningyu;QI Xiangqian;YANG Wei(Department of Ophthalmology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Ningxia Blinding Eye Disease of Clinical Medical Research Center,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院眼科,宁夏银川750002 [2]宁夏致盲性眼病临床医学研究中心,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第7期591-594,共4页Ningxia Medical Journal

基　　金：国家自然科学基金项目(81960134)。

摘　　要：目的探讨提上睑肌腱膜前徙术矫正双眼轻度先天性上睑下垂的临床特征。方法选取双眼轻度先天性上睑下垂患者为实验组,共23例(46只眼),采用提上睑肌腱膜前徙手术,分析其术后额纹及上睑倒睫改善情况。并与既往同年龄段的23例(46只眼)双眼重度上睑下垂患者(对照组)屈光状态进行比较。分析未经手术治疗的轻度及重度上睑下垂与近视及散光的关系、与远视及弱视的关系。结果23例实验组患者中,12名患者行准分子激光术前检查时发现倒睫,要求行倒睫矫正手术时发现上睑下垂。6例患者因高度散光,发现上睑下垂。3例患者自觉眼睛小而无神,要求行重睑手术时发现上睑下垂。仅有2例患者考虑上睑下垂以上睑下垂首诊。有43只眼合并近视,29只眼合并散光,3只眼合并弱视。20例患者存在明显额纹,占比为86.9%;上睑倒睫14人,占比为60.9%。术后所有患者额纹明显缓解,上睑倒睫均矫正。对照组患者弱视发生明显高于实验组,差异有统计学意义(P<0.05);2组患者近视、远视、散光的发生率比较差异无统计学意义(P>0.05)。结论提上睑肌腱膜前徙手术,能很好地纠正轻度上睑下垂,明显改善额纹和上睑倒睫,术后患者满意度高。轻度上睑下垂与近视和散光的关系还需进一步研究。Objective To explore the clinical characteristics of levator aponeurosis in the correction of mild congenital ptosis in both eyes.Methods A total of 23 patients(46 eyes)with mild congenital ptosis in both eyes were selected as the experimental group and were operated with anterior migration of the levator ani tendon membrane to analyze the improvement of frontal lines and upper eyelid impaction after surgery.The refractive state of 23 patients(46 eyes)with severe ptosis was compared with that of 23 patients(46 eyes)with severe ptosis(control group).The patients with mild and severe ptosis without surgical treatment were analyzed in relation to myopia and astigmatism,and in relation to hyperopia and amblyopia.Results Among the 23 patients in the experimental group,12 patients were found inverted eyelashes on preoperative excimer laser examination and ptosis was detected when they asked for inverted eyelashes correction.Six patients were found ptosis due to high astigmatism.3 patients had small eyes and were self-conscious about their eyes and ptosis was detected when they asked for blepharoplasty.Only 2 patients were considered ptosis as the first consultation for ptosis.There were 43 eyes with combined myopia,29 eyes with combined astigmatism and 3 eyes with combined amblyopia.There were obvious forehead lines in 20(86.9%),and epiglottis in 14(60.9%).After operation,the forehead lines of all patients were significantly relieved and the upper eyelid trichiasis was corrected.The incidence of amblyopia in the control group was significantly higher than that in the experimental group(P<0.05),but there was no significant difference in the incidence of myopia,hyperopia and astigmatism between the two groups(P>0.05).Conclusion The anterior migration of the levator palpebrae muscle tendon membrane can well correct mild ptosis,significantly improve forehead lines and upper eyelid impingement,and it can provide high patient satisfaction after surgery.The relationship between mild ptosis and myopia and astigmatism needs fur

关 键 词：先天性上睑下垂 倒睫 额纹 腱膜前徙 

分 类 号：R777.1[医药卫生—眼科]