腱膜性上睑下垂的手术治疗

Surgical treatment for aponeurotic ptosis

目的 探讨矫治腱膜性上睑下垂的手术方法 ,并评价其临床效果。方法 对 13例 18眼腱膜性上睑下垂 ,经一个 10mm长的眼睑皱折皮肤切口施行上睑提肌腱膜修复术。手术前后测量上睑缘与角膜中心反光之间的距离 ,并于术后观察上睑形态。结果 术前上睑缘与角膜中心反光之间的距离平均为 ( 0 8± 0 3 )mm。随访时间 4～ 13月 ,平均 6 8月。术后上睑缘与角膜中心反光之间的距离平均为 ( 3 8± 0 4)mm。 1眼轻度欠矫 ,1眼轻度成角畸形。 16眼上睑高度和弧度令人满意。结论 本术式方法简单 ,可于门诊进行 ,创伤较轻 ,恢复较快 ,适用于经仔细选择的腱膜性上睑下垂。

Objective To explore a new surgical technique and evaluate its effectiveness for aponeurotic ptosis through a small skin incision.Methods The modified levator repair was performed through a 10 mm eyelid crease incision on 18 eyes (13 patients) of aponeurotic ptosis.Distance between upper eyelid margin and corneal reflection was measured before and after surgery.Postoperative upper contour was observed.Results The mean preoperative distance between upper eyelid margin and corneal reflection was (0.8±0.3) mm.The follow-up period was 4-13 months (average 6.8 months).The mean postoperative distance between upper eyelid margin and corneal reflection was (3.8±0.4)mm.One eyelid was mildly undercorrected,and one demonstrated moderately peaked contour postoperatively.Satisfactory eyelid position and contour were achieved in 16 of 18 treated eyelids.Conclusion This approach is simple and effective for a carefully selected patients with aponeurotic ptosis.Operating process can be done in the operating room of the Out-patient Department,the trauma is not so serious that it take little time to recover.