额肌SMAS瓣悬吊术治疗复发性上睑下垂28例分析

Clinical report of frontal muscle SMAS flap suspension surgery on the treatment of 28 cases recurrent ptosis

目的探讨上睑下垂手术失败后，再次手术矫正的方法及效果。方法在局部麻醉下采用额肌SMAS瓣悬吊术对28例32只眼术前检查额肌功能正常的复发性上睑下垂患者进行再次手术矫正，利用额肌SMAS瓣的提上睑作用，恢复上眼睑的正常功能。结果患者28例32只眼，手术均采用额肌SMAS瓣悬吊术，术后切口均一期愈合，随访6个月，睑缘弧度无畸形，双重睑自然，睁眼时上睑缘位于角膜上缘下1～2mm或与健眼基本对称，无上睑下垂复发。结论上睑下垂手术失败后，眼睑局部手术造成的瘢痕粘连严重，再次手术矫正比较复杂，有一定难度，若患者术前检查额肌功能正常，采用额肌SMAS瓣悬吊术进行再次手术矫正，是一种可行的术式。

Objective To explore ptosis surgery after failure, reoperation correction methods and effect. Methods Under local anesthesia, the frontal muscle SMAS flap suspension surgery were performed on 28 cases （32 eyes） with normal frontal muscle function on preoperative examination that had recurrent ptosis patients with surgical correction again, and made use of the frontal muscle flap of SMAS put on eyelid function and restored the normal function of the upper eyelid. Results All 28 cases （32 eyes） used frontal muscle SMAS flap suspension surgery, postoperative incision were primary healing, followed up for 6 months. Upper eyelid radian was no deformity, double eyelid nature, open eyes on when blepharitis located in corneal margin on the 1-2 mm or with health eye basic symmetric, no blepharoptosis recurrence happened. Conclusions Frontal muscle SMAS flap suspension surgery method is a kind of feasible operation for correction of ptosis surgery failure cases if the patients with normal frontal muscle function preoperatively.