额肌悬吊术治疗上睑下垂(附71例临床分析)

FRONTAL MUSCLCES SUSPENSION FOR TOPSIS OF UPPER EYELID

研究目的探讨额肌悬吊术治疗上睑下垂的疗效。研究设计用额肌悬吊术治疗上睑下垂71例103只眼,观察其疗效。研究单位新乡市第一人民医院眼科新乡铁路医院研究对象上睑下垂71例,103只眼;双眼29例,单眼42例;年龄最小1.5岁,最大62岁;其他手术失败者9例,其中4例为第三次手术;103只眼中,92只眼为重度,11只眼为中度。处理方法术前测量额肌肌力,提上睑肌肌力,下垂量,眉睫间距离,上睑皮肤伸展度。按重睑术设计切口,沿皮下向上分离至眉上1.5～2cm,在眶上缘眼轮匝肌与额肌交界处横行剪开约2～2.5cm,在额肌下分离范围同上,游离额肌,通过睑部轮匝肌下,将额肌固定在1/2睑板上,皮肤按重睑术缝合。结果用此术式治疗后,睑裂闭合不全较其他术式恢复快,睁闭眼自如,无疤痕,随访3年多,受术者均达到双眼重睑一致。结论额肌悬吊术是治疗上睑下垂的理想术式。

study objective To search Therapeutic effcet of frontal muscles suspensiion for topsis of upper eyelid. Design seventy-one patients (103 eyes) with topsis of upper eyelid are treated surgically by using frontal muscles suspcsion. The therapeutic effects are observed systemically. Setting Department of ophthalmology, first people's hospital of xinxiang eity. Patients seventy one patients (103 eyes) with topsis of upper eyelid, bibocular topsis of upper eyelid are 29 patients, monocular are 42 patients.The range of age is from 1.5 to 60years old.In this series, 9 patients had failured effects by other surgical methods, includiing patients underweent third surgery. Among of 103 eyes, 92 eyes are severe and middle topsis of upper eyelid. Interventions Before operation, myodynamia of frontal muscle of upper eyelid, and topsis degrees, intcrsupcrciliary width, extens or degrees of skin are measured. The operation ineision is designed by surgery of double-fold eyelid and skin are dissociated per-subcutaricouslly up to 1.5～2.0 cm above superciliary and transection at 2～2.5cm the junction between orbicular muscles and frontal muscles. The dissocition range of frontal sub-muscles is similarly with above mentioned. The frontal muscles are fixed on 1/2 tarsus under the orbical muscles of eye. Skin suture are performed by surgery method of double-fold eyelid. Results By this operation, palpcbral fissure dysraphism recovered guickly, and palpebral fissure open and close freely, and cicatrization are not found.The patients followed up 3 years, similar double-fold eyeclid in both eyes are performed. Conclusion The frontal muscles suspension is a satisfactory method for topsis of upper eyelid.