联合筋膜鞘悬吊治疗悬挂支撑结构张力低下性重度上睑下垂

Conjoint fascial sheath suspension in treatment of severe blepharoptosis caused by inadequate suspension system tension

目的探讨联合筋膜鞘悬吊术治疗悬挂支撑结构张力低下性重度上睑下垂的方法。方法2014年9月至2017年9月,北京睐美安医疗美容诊所用联合筋膜鞘悬吊术治疗重度上睑下垂患者62例(89眼),其中女51例、男11例,年龄19~54岁。对手术前后上睑缘中央到角膜反光点距离(MRD-1)、重睑形状、外观、不良反应等指标给予记录和统计学处理。结果89患眼术前MRD-1值均为-3 mm~+1 mm,术后MRD-1为+1 mm~+4 mm,治疗前后比较,差异有统计学意义(t=5.893,P<0.05)。治愈82眼(92.1%),改善7眼(7.9%);无严重并发症。结论联合筋膜鞘悬吊术不会对悬挂固定系统造成进一步破坏,是重度上睑下垂患者的首选手术方法。

Objective To evaluate the safety and efficacy of conjoint fascial sheath(CFS)suspension surgery for severe blepharoptosis caused by low-tension suspension system.Methods A total of 62 cases with severe blepharoptosis caused by low-tension suspension system received CFS suspension correction surgery from September 2014 to September 2017 were collected and followed up with a range of 12-36 months.The MRD-1,curve of upper eyelid,appearance and complications were recorded and underwent statistical analysis to evaluate the effect based on functionality,aesthetics and complication.Results The postoperative MRD-1 was+1 mm~+4 mm compared with preoperative-3 mm~+1 mm.The difference in the mean change was statistically different(t=5.893,P<0.05).The satisfactory rate was 92.1%(82 cases),7.9%(7 cases)were improved,and no case was invalid.There were no cases of recrudescence.Conclusions Severe blepharoptosis can be caused by the inadequate tension of the upper eyelid suspension system.Laxity and abnormality of fixed structures may be major cause of decreasing levator aponeurotic tone.CFS suspension prevents further damage to the previous fixed structures,so it should be the first choice for such cases.