改良上睑提肌缩短术矫正先天性中重度上睑下垂

Therapeutic effect of modified levator palpebrae superioris shortening on congenital moderate to severe blepharoptosis

目的评估改良上睑提肌缩短术矫正先天性中重度上睑下垂的临床疗效。方法收集我科2015年2月～2017年4月收治的中重度上睑下垂患者45例(46眼),其中中度6例、重度39例。所有患者均接受改良上睑提肌缩短术。沿睑板上缘离断上睑提肌-Müller肌复合体并向上分离后与睑板固定,而后将复合体断端缝合到睑板上1/3部浅层。结果术后随访6个月,42例疗效满意(睑缘弧度自然,上睑缘遮盖角膜上缘<2 mm,双眼形态基本对称),2例过矫(上睑缘位于上方角膜缘外),1例出现结膜脱垂。结论改良上睑提肌缩短术治疗先天性中重度上睑下垂效果确切,在矫正眼睑生理功能和形态改善上可达到满意效果,值得临床推广。

Objective To evaluate the clinical effect of modified levator palpebrae superioris shortening on moderate to severe congenital blepharoptosis. Methods Forty-five cases (46 eyes) with moderate to severe blepharoptosis who were admitted to the Department of Facial Plastic and Reconstructive Surgery, Eye Ear Nose and Throat Hospital of Fudan University, including 6 cases of moderate blepharoptosis and 39 cases of severe blepharoptosis. All patients were treated with modified levator palpebrae superioris shortening. The levator palpebrae superioris -Müller complex was cut off along the edge of the eyelid and separated and fixed with the eyelid, then the broken end of the complex was sutured to one third of the superficial layer of the eyelid. Results After 6 months of follow-up, 42 cases were satisfied (the upper eyelid margin was natural, the upper eyelid margin covered the upper corneal margin < 2 mm, the shape of both eyes was basically symmetrical), 2 cases were overcorrected (the upper eyelid margin was outside the upper corneal margin), and 1 case had conjunctival prolapse. Conclusions Modified levator palpebrae shortening is effective in the treatment of moderate to severe congenital blepharoptosis. Satisfactory results may be achieved in the correction of physiological function and morphological improvement of the eyelids, which is worthy of clinical promotion.