额肌筋膜悬吊术和上睑提肌缩短术治疗中重度先天性上睑下垂的疗效比较

Comparison of the effects of FMFS and LS in the treatment of moderate to severe congenital ptosis

目的探讨中重度先天性上睑下垂患者应用额肌筋膜悬吊术和上睑提肌缩短术治疗的疗效。方法选取于2018年5月~2021年3月就诊的98例(145眼)中重度先天性上睑下垂患者,按手术方法分为试验组(n=49,73眼)与对照组(n=49,72眼)。对照组行上睑提肌缩短术,试验组则行额肌筋膜悬吊术。比较2组手术前后眼睑状况与额肌力;统计2组术后矫正率和并发症发生情况。结果2组患者均未出现过度矫正和未矫正情况的发生,试验组术后矫正率为95.89%,较对照组的83.33%升高(P<0.05)。术后1、6个月试验组患者上睑回退量小于对照组(P<0.05),额肌力评分高于对照组(P<0.05);试验组术后睑裂高度较对照组差异无统计学意义(P>0.05)。术后2组并发症发生率差异无统计学意义(P>0.05)。结论中重度先天性上睑下垂患者应用FMFS和LS的疗效确切,相对于LS,FMFS可更有效改善患儿眼睑状况,且临床满意度高。

Objective To investigate the efficacy of frontalis fascia suspension(FMFS)and levator levator muscle shortening(LS)in patients with moderate to severe congenital blepharoptosis.Methods A total of 98 patients(145 eyes)with moderate to severe congenital ptosis were selected from May 2018 to March 2021.They were divided into experimental group(n=49,73 eyes)and control group(n=49,72 eyes).LS was performed in the control group and FMFS was performed in the experimental group.The eyelid condition and frontal muscle strength were compared between the two groups before and after the operation;the postoperative correction rate and complications of the two groups were counted.Results There was no overcorrection and uncorrection in the two groups.The postoperative correction rate in the experimental group was 95.89%,which was higher than 83.33%in the control group(P<0.05).At 1 and 6 months after operation,the amount of upper eyelid retraction in the experimental group was smaller than that in the control group(P<0.05),and the frontal muscle strength score was higher than that in the control group(P<0.05);the postoperative palpebral fissure height in the experimental group was not significantly higher than that in the control group(P>0.05).There was no significant difference in the complication rate between the two groups(P>0.05).Conclusion The efficacy of FMFS and LS in patients with moderate to severe congenital ptosis is definite.Compared with LS,FMFS can improve the eyelid condition of children more effectively,and the clinical satisfaction is high.