两种术式治疗重度先天性上睑下垂的效果观察

目的探讨应用上睑提肌缩短术、额肌瓣悬吊术治疗重度先天性上睑下垂的疗效。方法重度先天性上睑下垂患者32例37眼，上睑提肌肌力≥4mm患者18例（22眼）行上睑提肌缩短术，上睑提肌肌力〈4mm患者14例（15眼）行额肌瓣悬吊术，比较术后效果、上睑弧度、双重睑成形情况及手术并发症。结果采用上睑提肌缩短术患者术后兔眼恢复时间短，外观自然，效果满意；采用额肌瓣悬吊术患者兔眼恢复时间长，外形欠自然。结论两种手术方式均能有效治疗先天性上睑下垂，但上睑提肌缩短术更符合生理状态，手术效果更好，且并发症少。

Comparative study on the two surgical procedures for severe congenital ptosis LUO Xiaoliang LEI Cheng

Objective To investigate the superiority and disadvantage of two operations for severe congenital ptosis. Meth- ods 37 eyes of 32 patients with severe congenital ptosis undergoing therapy were divided into two groups. 18 cases （22 eyes） with myodynamia of levator palpabra muscle ≥ 4 mm were treated by levator palpebra superioris muscle shortening, 14 cases （15 eyes） with myodynamia of levator palpabra muscle 〈 4 mm were treated by frontal muscle flap suspension surgery. The postoperative effects, upper eyelid radian, double eyelid forming conditions and complications were compared. Results The cases which were conducted levator palpebra superioris muscle shortness had short recovery time, natural ap- pearance and satisfactory results. And the others had long recovery time and unnatrual appearance. Conclusion Both sur- gical methods can treat congenital ptosis effectively. Shortening levator muscle of upper eyelid is more suitable for physiol- ogy status and has the best effects and fewer complications.