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上睑提肌缩短上横韧带悬吊治疗重度上睑下垂 总被引:5,自引:2,他引:5
目的 探讨治疗重度先天性上睑下垂的有效手术方法。方法 对 3 1例 (4 3眼 )平均年龄 11. 2 5岁的重度先天性上睑下垂施行上睑提肌缩短联合上横韧带悬吊术。此改进的术式与常规术式不同之处在于将上睑提肌缩短术与上横韧带悬吊术两种手术相结合。结果 术后随访 6月~ 2 5年 ,平均 1 5年。治愈 41眼 ,治愈率 95 . 3 5 %,效果满意。结论 上睑提肌缩短联合上横韧带悬吊术治疗重度上睑下垂效果肯定 ,在改善功能和美学方面优势明显。 相似文献
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目的 探讨上睑提肌缩短并上横韧带徙前固定于睑板的方法治疗中重度先天性上睑下垂的效果。方法 对11例(17眼)中重度先天性上睑下垂进行上睑提肌缩短合并上横韧带徙前手术治疗。结果 上睑下垂矫正满意11眼(64.71%).矫正良好5眼(29.41%),矫正不足1眼(5.88%)。结论 借助上横韧带的力量增加上睑提肌缩短的作用达到提上睑的目的,手术成功率高,矫正效果满意。 相似文献
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提上睑肌缩短联合上横韧带加强术治疗复发性上睑下垂 总被引:6,自引:1,他引:5
目的 观察应用提上睑肌缩短联合上横韧带加强术治疗复发性上睑下垂的效果。方法 依据上睑下垂的程度和肌力 ,确定提上睑肌缩短量 ;将提上睑肌缩短与上横韧带一并作双套环缝线 ,缝合固定在睑板上缘。结果 本文 1 9例 2 1眼 ,平均随访 1 3 5个月。术后睑裂高度 7~ 9mm者 1 9眼 ,6~ 7mm者 2眼 ,双眼睑裂对称 ,重睑弧度自然 ,无睑裂闭合不全和暴露性角膜炎等并发症发生。结论 应用提上睑肌缩短联合上横韧带加强术治疗复发性上睑下垂 ,是一种有效的手术方法 相似文献
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提上睑肌缩短术矫正重度先天性上睑下垂 总被引:4,自引:4,他引:0
左吉盘 《眼外伤职业眼病杂志》1997,19(1):49-50
先天性上睑下垂是一种常见病。手术矫正是其主要的治疗方法。作者自1984年用提上睑肌缩短术矫正重度先天性上睑下垂18例20眼,效果较满意。经过1-10年观察,末发现复发和严重并发症。现报告如下:一般资料:18例20眼均为重度单纯性先天性上睑下垂。双眼2例,占11.1%,单眼16例,占88.9%,右眼11眼,占55%,左眼9眼,占45%。男8例,占44.4%,女10例,占55.6%,男:女为1:1.25;年龄最小5岁,最大53岁,平均19.8岁。年龄最大53岁的女病例,4年前曾在外院行额肌悬吊术失败后行提上睑肌缩短术得到矫正。术前检查:1视力:1.0~1.… 相似文献
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提上睑肌缩短并上横韧带徒前术矫治复发性上睑下垂 总被引:1,自引:0,他引:1
提上睑肌缩短并上横韧带徒前术矫治复发性上睑下垂哈尔滨市第五医院眼科王玉清,王镜清哈尔滨医科大学附属第一医院眼科孟祥成我们采用提上睑肌缩短术并上横韧带徙前术治疗8例复发性上睑下垂收到满意效果。临床资料8例先天性上睑下垂术后复发病人,女性5例,男性3例。... 相似文献
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张水江 《中国斜视与小儿眼科杂志》2007,15(1):32-33
目的评估经典提上睑肌缩短术治疗重度先天性上睑下垂及手术治疗效果。方法重度先天性上睑下垂20眼行经典提上睑肌缩短术结果本文16例20眼,平均随访6个月。术后睑裂高度7~9mm者18眼,6mm者2眼,双眼睑裂对称,重睑弧度自然,部分病例有轻度睑裂闭合不全,4眼一过性轻度结膜脱垂。结论该术式矫正重度先天性上睑下垂效果良好。 相似文献
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上睑提肌缩短术治疗重度先天性上睑下垂 总被引:1,自引:0,他引:1
目的探讨重度先天性上睑下垂的手术方法。方法对44例(56眼)8~60岁重度先天性上睑下垂施行上睑提肌缩短术。结果55眼一次手术成功,l眼二次手术成功,44例(56眼)重度先天性上睑下垂均矫正良好,双重睑形成自然美观,无严重并发症。结论上睑提肌缩短术符合眼解剖和生理规律,效果良好,是治疗重度先天性上睑下垂的有效方法。 相似文献
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改良式上睑提肌缩短术 总被引:1,自引:1,他引:0
目的:为先天性上睑下垂寻求简便的手术方法,以达到功能和美学的双重效果。方法:回顾性分析1994-1999年我院施行改良式上睑提肌缩短术治疗31例(33眼)先天性上睑下垂情况,手术方法的要点:利用中横韧带或上睑提肌腱膜悬吊矫正上睑下垂。结果:术后早期睑缘覆盖角膜缘1-3mm者达93.8%,上睑缘弧度及双重睑形成良好。双侧眼窝深度对称。术后仅部分病例早期有轻度闭合不全,结论:该术式在改善提睑功能方面与传统上睑提肌缩短术无差别,但手术方法简单,效果肯定,不影响眼部固有解剖关系,采用可调式缝线,不影响二次手术。 相似文献
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提上睑肌缩短术在治疗中重度先天性上睑下垂中的应用 总被引:4,自引:2,他引:4
目的:观察应用提上睑肌缩短术治疗中重度先天性上睑下垂的效果。方法:对39例(56眼)中重度先天性上睑下垂患采用经皮肤-睑结膜入路提上睑肌缩短术。并对术后效果进行随访观察。结果:本组39例(56眼)随访2~18mo,除2眼矫正不足外,余均获得良好效果。上睑缘弧度及双重睑形成良好,术后仅部分病例早期有轻度睑裂闭合不全,无暴露性角膜炎等并发症发生。结论:提上睑肌缩短术可适用于中重度先天性上睑下垂患,在矫正畸形和改善外观方面均能达到良好的效果。 相似文献
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目的 探讨根据术中对提上睑肌肌张力评估采取的单纯提上睑肌缩短术对儿童重症先天性上睑下垂的疗效方法 对169例(216只眼)重症先天性上睑下垂患儿,根据术中实际提上睑肌肌张力的评估,设计手术方式及手术量,其中143例(182只眼)行单纯提上睑肌缩短术,结果 169例(216只眼)术后6个月至2年随访,上睑缘位置均在瞳孔以... 相似文献
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提上睑肌腱膜瓣-额肌吻合术治疗重度上睑下垂 总被引:6,自引:5,他引:6
目的:观察提上睑肌腱膜瓣—额肌吻合术矫治重度上睑下垂的治疗效果。方法:对22例(28眼)先天性重度上睑下垂患者采用上睑皮肤双切口,制作提上睑肌腱膜瓣及额肌瓣,经眶膈后隧道将提上睑肌腱膜瓣于眉部辅助切口与额肌瓣吻合。结果:随访3mo~2a。21例(27眼,96%﹚术后效果良好,1例(1眼,4%﹚轻度矫正不足。结论:该术式具有矫治效果好、术中额肌剥离范围小、损伤轻、术后重睑形成自然美观等优点。是重度上睑下垂理想的手术方式。 相似文献
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提上睑肌缩短术治疗重度先天性上睑下垂 总被引:4,自引:4,他引:4
目的:探讨采用提上睑肌缩短术治疗重度先天性上睑下垂的效果及可行性。方法:对30例(34眼)患重度先天性上睑下垂患者,分别在局麻下行经皮肤面的提上睑肌缩短术,术前均进行详细的检查以除外垂直肌麻痹,jew-wink现象,重症肌无力等,bell( )现象,上睑下垂程度用berke法:均>4mm以上,提上睑肌功能均<4mm以下,缩短量为18~24mm。结果:30例(34眼)重度先天性上睑下垂患者经用提上睑肌缩短术治疗均获满意效果,上睑缘位于角膜缘下1~3mm,双侧睑裂大小,重睑高度基本一致,睑缘弧度自然流畅,睑闭合无角膜暴露,皱额耸眉姿态消失,随诊0.5~3a,效果满意。结论:经皮肤面的提上睑肌缩短术术野暴露好,可最大限度的充分游离提上睑肌,且年龄小,肌肉弹性好,矫正度数大,可以矫正重度先天性上睑下垂,且效果确实,可行。 相似文献
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Aleksandra Iljin Anna Zielinska Michal Karasek Andrzej Zielinski Aleksandra Omulecka 《Ophthalmic surgery, lasers & imaging》2007,38(4):283-289
BACKGROUND AND OBJECTIVE: To evaluate structural and ultrastructural abnormalities of the levator palpebrae superioris (LPS) complex in patients with congenital blepharoptosis. PATIENTS AND METHODS: Samples of the LPS complex were obtained from patients operated on for congenital blepharoptosis between 2000 and 2001 and studied under light microscopy (15 cases) and electron microscopy (9 cases). RESULTS: Findings of light microscopy evaluation of the LPS complex correlated closely with the clinical grading of congenital blepharoptosis-hypoplasia, decreased number and varying diameter of muscle fibers, and fibrous tissue hyperplasia in the endomysium and perimysium. The Müller's muscle preserved a normal appearance. Mild blepharoptosis revealed proliferation of collagen fibers on electron microscopy. Moderate blepharoptosis showed abnormal distribution of myofibrils and distortion of the tubular system and mitochondria in addition to the changes observed in mild blepharoptosis. Severe blepharoptosis showed mitochondria loss, cytoplasm thinning, and homogenous fiber areas in addition to the changes observed in mild and moderate blepharoptosis. CONCLUSIONS: The clinical degree of severity of congenital blepharoptosis correlates positively with the degree of histopathologic changes in the levator palpebrae superioris muscle. 相似文献
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R W Neuhaus 《American journal of ophthalmology》1985,100(2):308-311
In patients with severe Marcus Gunn jaw-winking, ablation of the synkinetic eyelid movement requires surgical removal of a significant portion of the levator complex (muscle and aponeurosis). As an alternative to removing this tissue completely, the levator muscle can be transected approximately 25 mm above its tarsal plate insertion. The distal levator muscle and aponeurosis can then be used as a suspensory material to suspend the eyelid to the eyebrow. 相似文献
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Bulent Yalcin MD Volkan Hurmeric MD Marios Loukas MD PhD R Shane Tubbs PhD Hasan Ozan MD 《Clinical & experimental ophthalmology》2009,37(4):407-411
Background: Accessory levator muscle slips may be associated with congenital eyelid retraction or blepharoptosis. Nevertheless, congenital retraction of the upper eyelid is a poorly defined entity about which little is known. Because of the clinical importance of the accessory levator muscle slip of the levator palpebrae superioris muscle, this study aimed to describe the morphological appearance of this variation in human adult orbits.
Methods: This study was undertaken in 60 orbits of 30 embalmed adult human cadavers, 17 men and 13 women, between the ages of 38 and 87 years at death. All cadavers were embalmed in 4% formalin solution.
Results: Three accessory levator muscle slips of the levator palpebrae superioris muscle were identified. One of these arose laterally from the origin of the levator palpebrae superioris muscle. At its anterior end, it divided into two parts, the main superior and a smaller inferior accessory. The second had an accessory levator fibromuscular slip. It arose medially from the origin of the levator palpebrae superioris and lost its muscular character after a short course. The third arose from the origin of the levator palpebrae superioris as a thin flat muscle.
Conclusions: Although many variations of the levator palpebrae superioris muscle have been reported in fetuses, investigation and demonstration of these may be more important in children and adults for ophthalmic surgery. We believe that detailed knowledge regarding the morphological appearance of an accessory levator muscle slip of the levator palpebrae superioris muscle may be useful for successful outcomes in ophthalmic surgery. 相似文献
Methods: This study was undertaken in 60 orbits of 30 embalmed adult human cadavers, 17 men and 13 women, between the ages of 38 and 87 years at death. All cadavers were embalmed in 4% formalin solution.
Results: Three accessory levator muscle slips of the levator palpebrae superioris muscle were identified. One of these arose laterally from the origin of the levator palpebrae superioris muscle. At its anterior end, it divided into two parts, the main superior and a smaller inferior accessory. The second had an accessory levator fibromuscular slip. It arose medially from the origin of the levator palpebrae superioris and lost its muscular character after a short course. The third arose from the origin of the levator palpebrae superioris as a thin flat muscle.
Conclusions: Although many variations of the levator palpebrae superioris muscle have been reported in fetuses, investigation and demonstration of these may be more important in children and adults for ophthalmic surgery. We believe that detailed knowledge regarding the morphological appearance of an accessory levator muscle slip of the levator palpebrae superioris muscle may be useful for successful outcomes in ophthalmic surgery. 相似文献
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提上睑肌缩短术治疗完全性先天性上睑下垂的临床观察 总被引:3,自引:0,他引:3
目的:观察提上睑肌缩短术治疗完全性先天性上睑下垂的疗效。方法:对25眼0肌力先天性上睑下垂患者行提上睑肌缩短徙前术,观察其手术效果。结果:25眼术后16眼睑裂高度正常,眼睑弧度自然,双眼基本对称;9眼矫正尚好,唯睑裂较对侧略小。无并发症发生。结论:手术矫正效果满意,外形自然,对0肌力先天性上睑下垂患者也应首选提上睑肌缩短术。 相似文献