改良上睑提肌缩短术治疗单侧先天性上睑下垂

Modified levator muscle resection for treatment of congenital unilateral ptosis

目的评估改良上睑提肌缩短术治疗单侧先天性上睑下垂的手术疗效。方法单侧先天性上睑下垂30例(30眼),术前参考健眼上睑缘位置以确定手术量,术中以可调整褥式缝合行改良上睑提肌缩短术。结果随访6个月,30眼中成功26眼(86.67%),其双眼睑裂对称,重睑弧度自然,部分病例有轻度闭合不全但闭合时不露角膜;有效4眼(13.33%),患眼睑裂高度低于健眼的值小于2mm,术眼无闭合不全或闭合不全不明显,但闭合时不露角膜。结论改良上睑提肌缩短术矫正单侧先天性上睑下垂效果良好。

Objective To evaluate the effectiveness of modified levator muscle resection for the treatment of congenital unilateral ptosis. Methods Thirty eyes from 30 patients with congenital unilateral ptosis underwent the modified levator muscle resection with a releasable mattress suture. The shortening of the upper eyelid levator was determined according to the location of upper eyelid of the healthy eye. Results The follow-up period was 6 months. Success was seen in twenty-six（86.67% ） eyes with symmetric palpebral fissure. Some eyes had light dysraphism. The operation was effective in 4 eyes（ 13.33% ） with the palpebral fissures less than 2 mm lower than that of the healthy eye, and without apparent dysraphism. The exposure of the corneas was not seen when the eyes were closed. The total effective rate was 100%. Conclusions The modified levator muscle resection has a good effect on the treatment of congenital unilateral ptosis.