重度先天性上睑下垂的手术治疗

The operation on serious congenital blepharoptosis

目的分析额肌筋膜瓣悬吊术和异体阔筋膜悬吊术矫正重度先天性上睑下垂的优缺点。方法对重度先天性上睑下垂66例87眼进行手术治疗,其中额肌筋膜瓣悬吊术30例45眼,异体阔筋膜悬吊术36例42眼,分析术后上睑下垂矫正效果、上睑弧度、双重睑成形及暴露性角膜炎发生情况。结果额肌筋膜瓣悬吊术取材方便、复发率较低、上睑弧度匀称;阔筋膜悬吊手术简单、重睑形成良好,但取材困难、复发率稍较高。结论额肌筋膜瓣悬吊术和阔筋膜悬吊术均能有效治疗重度先天性上睑下垂,前者无需特殊材料,术后效果较稳定。

Objective To analyse the merits and defects of correcting serious congenital blepharoptosis by frontalis aponeurosis flap suspension and banked fascia flap suspension. Methods 87 eyes of 66 cases with serious congenital blepharoptosis underwent operations,45 eyes of 30 cases underwent surgery of frontalis aponeurosis flap suspension. 42 eyes of 36 cases underwent the surgery of banked fascia flap suspension. The results of corrected blepharoptosis, arc of upper eyelid, double-fold eyelid and exposure keratitis were analysed, Results The surgery of frontalis aponeurosis flap suspension had low recurrence and good outcorns. The surgery of banked fascia flap suspension had better double-fold eyelid,but had higher recurrence. Conclusions The surgery of frontalis apeneurosis flap suspension and banked fascia flap suspension are both effective methods in correcting serious congenital blepharoptosis, The effect of frontalis aponeurosis flap suspension is reliable and need not special meaterial.