上睑下垂矫正术后发生角膜溃疡的特殊原因及处理

The cause and treatment for corneal ulcer after ptosis surgery

目的探讨上睑下垂术后角膜溃疡发生的特殊原因及处理措施。方法回顾性分析深圳市眼科医院2012年1月至2013年12月进行的上睑下垂矫正术89例（110眼），其中5例（6眼）发生了角膜溃疡，分析其原因及治疗效果。结果5例（6眼）发生角膜溃疡，3例是因为术后下睑倒睫加重而引起，1例与心因性疾病有关，1例是因为脑膜瘤术后，角膜营养不良引起。进行了睑裂缝合、营养角膜、对症治疗等处理，患者角膜均恢复透明，上睑下垂手术效果满意。结论上睑下垂患者虽然在术前、术后均采取措施避免角膜溃疡的发生因素，但还是有少数患者术后发生角膜溃疡，其原因并不常见。术前完善检查，术后出现溃疡后积极处理，是可以避免或治愈角膜溃疡的。

Objective To analyze special cause and treatment for corneal ulcer after ptosis surger- y. Methods 110 eyes of 89 patients who underwent blepharoptosis correction surgery between January 2012 and December 2012 were retrospectively analyzed. Corneal ulcer occurred in 5 cases （6 eyes）. The causes and treatment were analyzed. ResuLts In 5 cases （6 eyes）, corneal ulcer was caused by entropion and tri- chiasis in 3 eyes of 3 cases. The corneal ulcer was related to the psychological illness in 2 eyes of 1 case. The nerve nutritional corneal ulcer occurred in 1 eye of 1 case because of meningioma surgery. After the treatments, such as tarsorrhaphy, cornea nutritional therapy and symptomatic treatment, all the corneal ulcer restored transparent and the effect of surgery was satisfactory. Conclusion Before and after ptosis surgery, patients have been taken measures to prevent the occurrence of corneal ulcer, but corneal ulear still occurs. The causes are not eommon. So improving preoperative examinations and postoperative active treatment are very necessary.