改良联合筋膜鞘悬吊术矫正复发性重度上睑下垂的临床研究

Clinical study of modified combined fascial sheath suspension on the treatment of recurrent severe blepharoptosis

目的:观察和评价改良联合筋膜鞘(combined fascial sheath,CFS)悬吊术治疗复发性上睑下垂的可行性和临床效果。方法:纳入2017年3月至2020年3月于河北省眼科医院眼整形门诊就诊的26例复发性重度上睑下垂患者(32只眼),均采用改良CFS悬吊术予以矫正。术后随访1年,分别于术后1个月、3个月、6个月及1年时复诊,对患者术后上睑缘中点到角膜反光点的距离(marginal reflex distance-1,MRD1)、眼皮折皱深度、长度、弧度和并发症等情况为主要观察指标给予记录和效果评估。结果:26例患者共32只患眼,临床治愈27只眼(84.4%),改善4只眼(12.5%),无效1只眼(3.1%),对1只无效眼术后6个月进行再次调整,调整后达到临床治愈标准。1例出现结膜脱垂,经过药物与加压包扎治疗后结膜脱垂症状消失,无暴露性角膜炎或其他并发症发生病例。结论:改良CFS悬吊术矫正复发性重度上睑下垂,具有操作简单、创伤小、治疗效果确切、并发症少等优点,值得临床推广与应用。

Objective:To observe and evaluate the feasibility and clinical effect of modified combined fascial sheath(CFS)suspension on the treatment of recurrent severe blepharoptosis.Methods:A total of 26 patients(32 eyes)with recurrent severe ptosis treated in Hebei Eye Hospital from March 2017 to March 2020 were included.All patients were corrected by modified CFS suspension.The patients were followed up for 1 year,and returned to the hospital at 1 month,3 months,6 months and 1 year respectively.The marginal reflex distance-1(MRD1),eyelid crease depth,length,radian,and complications were recorded as the main observation indexes and the effect was evaluated.Results:In the 32 eyes of 26 patients,27 eyes(84.4%)were completely corrected,4 eyes(12.5%)were improved,while 1 eye(3.1%)had no improvement,the invalid eye was adjusted again 6 months after operation,and reached the effective standard after adjustment.Conjunctival prolapse occurred in 1 case,and the symptoms of conjunctival prolapse disappeared after the treatment with drugs and pressure dressing,and no case of exposure keratitis or other complications occurred.Conclusion:Modified combined fascial sheath suspension is an effective method on the treatment of recurrent severe blepharoptosis with the advantages of simple operation,less trauma,definite therapeutic effect,and fewer complications,which is worthy of clinical promotion and application.