复发性先天性上睑下垂的手术疗效分析

Outcomes of surgical treatment for recurrent congenital ptosis

目的评价复发性先天性上睑下垂的手术疗效。方法15例（15只眼）复发性先天性上睑下垂患者，术前根据患者提上睑肌的肌力结合上次手术方式确定再次手术方式，提上睑肌力〈4mm者采用直视下额肌瓣悬吊术，提上睑肌力≥4mm者采用提上睑肌缩短术，术后追踪随访6-12个月，对手术方式和疗效进行回顾性分析。结果所有病例均获得满意疗效，上睑形态自然，睑缘弧度良好，上睑缘位于角膜缘下1-2mm，双眼基本对侧。结论复发性上睑下垂的再次手术需要个性化处理，仍需要根据提上睑肌肌力来确定再次手术方式。

Objective To evaluate the effect of surgical treatment in patients with recurrent congenital ptosis. Methods A total of 15 patients （ 15 eyes） with recurrent congenital ptesis received surgeries. Procedure type was determined according to patlent＇s levator muscle strength of upper eyelid and medical history. For the patients with levator muscle strength 〈 4 mm, frontalis flap suspension was used; for those with levator muscle strength ≥4 mm, levator shortening was used. All patients were followed-up for 6 - 12 months. Results All patients had a satisfactory eyelid position after 6 - 12 months of follow-up. Conclusion Personalized surgery offers optimal outcomes in the treatment of recurrent congenital ptosis. Levator muscle strength is a critical factor for the choice of surgical methods.