限制韧带松解在矫正先天性轻度上睑下垂的重睑术中的应用

The effectives of releasing the fibrous bundles across levator muscle in double eyelid blepharoplasty with mild blepharoptosis

目的:在重睑术前应重视先天性轻度上睑下垂的诊断并探讨应用限制韧带松解术在治疗先天性轻度上睑下垂中的临床意义。方法:对临床要求重睑的患者,通过"抬眉/额纹增多、仰颏、抬眼费力"三联症初步判断是否同时有轻度上睑下垂的存在;对确诊为先天性轻度上睑下垂患者,通过单纯松解限制韧带即可矫正大部分患者,不完善者加行上睑提肌腱膜缩短术。结果:本组23例33只眼,19例26只眼在重睑术中行单纯限制韧带松解术,4例7只眼行限制韧带松解术+上睑提肌腱膜折叠缩短术。随访3个月～2年,所有患者对上睑下垂矫正效果均满意,左右对称,外形自然,抬眼明显轻松,无复发。结论:在重睑术前应重视对先天性轻度上睑下垂的诊断,限制韧带松解术是治疗先天性轻度上睑下垂的首选方法,对于大部分患者可达到完全矫正的效果,且形态自然,不易复发。

Objective To stress the importance of diagnosis of mild blepharoptosis before double eyelid blepharoplasty and to investigate the role of releasing the fibrous bundles across levator muscle in correction of mild blepharoptosis. Methods For patients seeking double eyelid blepharoplasty, the diagnosis of mild blepharoptosis was based on the three symptoms including , lifting eyebrow with more frontal wrinkles, lifting jaw,lifting upper eyelid with efforts＂. For patients with mild blepharoptosis, simply releasing the fibrous bundles across levator muscle could correct most mild blepharoptosis. A further procedure can be added to shortening the levator aponeurosis if necessary. Results Of the 33 eyes in 23 cases, 26 eyes in 19 cases received simple release of the fibrous bundles across levator muscle,7 eyes in 4 cases received both releasing and shortening the fibrous bundles across levator muscle. The follow-up ranged from 3 months to 2 years. All patients gained complete recovery, symmetry,and natural appearance. They felt easy lift of upper eyelid and were exempt from recurrence. Conclusion Stressing the importance of diagnosis of mild blepharoptosis before double eyelid blepharoplasty and releasing the fibrous bundles across levator muscle in correction of mild blepharoptosis are primary choices. For most patients, the method can gain complete recovery, natural appearance, and rare recurrence.