提上睑肌缩短术治疗儿童重度上睑下垂

Shortening operation of the levator palpebrae muscle in children with severe ptosis

目的:观察提上睑肌缩短术治疗肌力<4mm的重度先天性上睑下垂的效果。方法:对肌力在4mm以下的重度先天性上睑下垂58例84眼行提上睑肌缩短术,观察并分析术后上睑的高度,睑裂宽度,上睑的弧度及重睑形态。结果:本组病例中,正矫64眼(76.2%);轻度欠矫(上睑缘位于上方瞳孔缘或上方瞳孔缘下1mm)18眼(21.4%),复发(上睑缘高度较术前无提高)2眼(2.4%)。欠矫的病例中有6例伴外侧1/3重睑沟变浅。无过矫病例,无暴露性角膜炎病例。结论:提上睑肌缩短术治疗肌力<4mm的重度先天性上睑下垂可取得满意效果。但在手术的最低年龄及探求少部分失败病例的原因等方面还有待进一步研究。

AIM： To abserve the effect of shortening the levator palpebrae muscle surgery in childred with severe congenital blepharoptosis and whose muscle strength is less than 4mm. METHODS： We treated 58 cases （84 eyes） of severe congenital blepharoptosis whose muscle strength is less than 4mm with shortening operation of the levator palpebrae musule. After surgery, observed and analyzed the height of postoperative upper eyelid, the width of palpebral fissure, the curvature of the upper eyelid and the morphology of double eyelid morphology. RESULTS： Sixty-four eyes（76.2%） accessed to good effect; 18 eyes （21.4%） are less than correction, 6 cases of these accompanied by lateral 1/3 double eyelid sulcus shallow preoperative （the upper eyelid located on the top margin or lmm higher than the pupillary margin） ; 2 eyes （12.4%） relapsed （the height of the margin of upper eye lid had not improved than preoperative）, no cases have been more than correction; no case accompanied exposure keratitis. CONCLUSION.. Shortening operation of the levator palpebrae muscle is a effective treatment of severe congenital ptosis （muscle strength is less than 4mm） ,and can obtain satisfacting results. However, to make sure the minimum age of surgery and explore the reasons of failure need further study yet.