应用赫林定律矫正不对称双侧上睑下垂的临床效果

Application of the Hering＇s law in corrective surgery for asymmetric bilateral ptosis

目的探讨应用赫林定律矫正不对称双侧上睑下垂的临床效果.方法 2014年1月至2016年7月,采用上睑提肌腱膜前徙术矫正不对称轻度、中度上睑下垂者165例,将其分成两组：A组15例,术中不应用赫林定律,先矫正较轻侧,再矫正较重侧;B组150例,均应用赫林定律,先矫正较重侧使睑缘达到角膜边缘相切或低0.5-1.0 mm,再矫正较轻侧与对侧对称.设定术后两侧睑裂高度对称性差异小于0.5 mm为满意,随访3-24个月.组间比较采用x2检验.结果 A组15例中满意10例（占66.67％）;B组1 50例中满意145例（占96.67％）;不满意者3个月后均应用赫林定律予以修复满意.组间比较差异有统计学意义（P＜0.05）.结论 术中应用赫林定律矫正不对称双侧上睑下垂,更能获得双眼对称的满意效果.

Objective To evaluate the clinical result of Hering＇s law in the correction of asymmetric bilateral ptosis.Methods From January 2014 to July 2016,165 cases divided into 2 groups with asymmetric bilateral ptosis in mild and moderate ptosis were corrected with aponeurosis advancement type correction：A group of 15 cases,in which the surgery does not consider the influence of Hering＇s law,the first correction of mild side,and then corrected the heavier side;B group of 150 cases,in which the Hering＇s law was applied,the first correction of severe side so that the margin reached the edge of the cornea is tangent or low 0.5-1.0 mm,and then corrected mild side.That the difference of symmetry between the two sides of the palpebral fissure was less than 0.5 mm,and the follow-up was more than 3 months.The Pearson chi square test was used to compare the differences between the two groups.Results In this group,165 cases were followed up for 3-24 months,10 cases （66.67%） was satisfactory in group A （15 cases）;145 cases （96.67%） was satisfactory in group B （150 cases）;After 3 months,all the failure cases got satisfactory result by using the Hering＇s law in corrective surgery again.The P value of chi square test between groups was less than 0.05.Conclusions The application of Hering＇s law in the correction of asymmetry bilateral ptosis is more satisfactory.