通过上睑缘切口入路矫正上睑下垂的术式应用探讨

Application Experience of Blepharoptosis Correction by Palpebral Marginal Incision

目的:探讨一种通过睑缘切口入路方式来矫正上睑下垂的手术方法。方法:2019年6月-2021年6月,笔者采用上睑缘切口矫正上睑下垂患者共28例(32只眼),其中提上睑肌前徙6例、提上睑肌缩短12例、CFS8例、上睑提肌缩短联合CFS2例。术前术后评估上睑缘角膜映光距离(MRD1)、睑裂大小、上睑提肌肌力、上眼睑外形满意度、睑缘切口瘢痕满意度、术后并发症(眼睑闭合不全、结膜脱垂、上睑下垂矫正不足、上睑下垂矫正过度)。结果:所有患者术后随访6~18个月,平均随访11.6月,术后满意率高(96.43%);所有患者MRD1、睑裂大小、上睑提肌肌力均得到显著改善(P<0.05),眼睑外形满意度及睑缘切口瘢痕满意度高;未出现结膜脱垂、上睑下垂矫正不足、上睑下垂矫正过度等并发症。结论:通过睑缘切口矫正上睑下垂在临床应用中具有术后消肿快、瘢痕不明显恢复后上睑自然美观等优点,较传统切口入路方式有更高的满意率,更具有美容应用的实际意义,可作为上睑下垂矫正术的一种补充术式,值得临床推广。

Objective To investigate a method to correct ptosis by palpebral marginal incision.Methods From June 2019 to June 2021,a total of 28 patients(32 eyes)were treated with palpebral marginal incision to correct ptosis,including 6 cases of levator muscle forward,12 cases of shortening of levator muscle of upper eyelid,8 cases of CFS and shortening of levator muscle of upper eyelid combined with CFS.The corneal light distance(MRD1)at the upper eyelid margin,the size of eyelid fissure,the strength of levator muscle of upper eyelid,the satisfaction of upper eyelid shape,the satisfaction of incision scar at the upper eyelid margin,and postoperative complications(eyelid insuffi ciency,conjunctival prolapse,inadequate correction of ptosis,and excessive correction of ptosis)were evaluated before and after surgery.Results All patients were followed up for 6 to 18 months,average 11.6 months.Postoperative satisfaction was high.MRD1,palpebral fi ssure size and levator muscle strength of upper eyelid were significantly improved in all patients(P<0.05).All patients had high satisfaction with eyelid shape and incision scar of eyelid margin.No complications such as conjunctival prolapse,inadequate correction of ptosis,and excessive correction of ptosis occurred in all patients.Conclusion Correct ptosis by palpebral marginal incision in the clinical application of postoperative swelling fast,no obvious scar after restoring upper eyelid advantages of natural beauty,the incision into the traditional way has a higher satisfaction,the practical signifi cance of the application is more beauty,can be used as a complementary ptosis correction for the operation,worthy of clinical promotion.