老年性上睑下垂合并上睑松弛的手术治疗

Surgical treatment of senile ptosis accompanying dermatochalasis

目的探讨老年性上睑下垂合并上睑松弛的手术方法及效果。方法对46例（61眼）老年性上睑下垂并上睑松弛分别行上睑提肌缩短或（上睑提肌腱膜折叠）眼睑皮肤松弛矫正术及眉下垂矫正联合手术。结果术后随访6-18个月，矫正满意者55眼；欠矫4眼；过矫2眼。欠矫者半年后再次行上睑提肌缩短术，效果良好；过矫者，其中1例半年后行上睑提肌延长术，得以矫正，另1例患者不愿意再次手术，术后并发暴露性角膜炎，长期在门诊治疗。随访期间，患者满意率达90．16％。结论联合手术治疗老年性上睑下垂并上睑松弛，可以改善视功能与外观，使老年患者的生活质量明显改善。

Objective To investigate the surgical method and efficacy for the treatment of senile ptosis and dermatochalasis. Methods Sixty-one eyes of 46 patients with senile ptosis and dermatochalasis underwent respectively the levator resection operation or plication of levator aponeurosis, with eyelid relaxation surgery and the eyebrow ptosis surgery. Results The follow-up period was 6-18 months. After surgery 55 eyes were satisfyingly corrected; 4 eyes were under-corrected and 2 eyes were over-corrected. The under-corrected patients recovered steadily after second levator resection operation 6 months later. Of the 2 over-corrected patients, 1 case got fine correction after second operation lengthening of the levator muscle 6 months later operation and the other one refused second surgical correction then complication of exposure keratitis occurred and was treated in outpatient clinic. The satisfaction rate was 90.16% during the follow-up time. Conclusion The combined surgery for the treatment of senile ptosis accompanying dermatochalasis can obviously improve the life quality of senior patients.