老年腱膜性上睑下垂手术治疗

目的探讨老年腱膜性上睑下垂的手术治疗方法,并评价其临床效果。方法对12例（21眼）老年腱膜性上睑下垂根据上睑下垂程度的不同,分别行上睑提肌腱膜折叠术或上睑提肌腱膜修复术。中度下垂6眼行上睑提肌腱膜折叠术,重度下垂15眼行上睑提肌腱膜修复术,术后随访3—12个月。结果20眼上睑缘位于角膜上缘下1．5—2．5mm,1眼上睑缘位于角膜上缘下4mm,所有病例上眶区凹陷明显改善,收到治疗和美容的双重效果。结论采取加强上睑提肌力量的手术方式治疗老年腱膜性上睑下垂,手术安全,效果好。     

腱膜性上睑下垂手术治疗观察

目的:探讨腱膜性上睑下垂的手术治疗方法及效果。方法:本组病例共9例12眼,男4例5眼,女5例7眼,均表现为后天性上睑下垂,上睑缘遮盖1/2～1/3瞳孔,提上睑肌肌力均在10mm以上,伴有上眶区凹陷,上睑皱壁增高,部分患者行新斯的明试验排除重症肌无力。手术均在局部麻醉下行提上睑肌腱膜分离修复术。结果:术后3～4wk内患者均有不同程度眼睑肿胀,眼睑闭合不全逐渐消失,随访4～18mo,患者双眼睑重睑基本对称,弧度流畅,上睑下垂矫正,上眶区凹陷明显改善,未出现眼睑内外翻及眼睑畸形等并发症,有1眼欠矫。结论:腱膜性上睑下垂行提上睑肌腱膜分离修补术,此法符合解剖和生理,保存了M櫣ller肌及提上睑提肌的内、外角,维持了眼睑正常结构。手术过程简单,损伤范围小,术后反应轻、效果好。     

腱膜性上睑下垂手术疗效观察

目的 根据腱膜性上睑下垂的临床表现与病理改变,寻求有效的手术治疗方法。方法 通过对22例（26只眼）腱膜性上睑下垂的术前检查及术中观察,针对术中发现的病理改变,完善手术方法。结果 22例（26只眼）患者中,19例（23只眼）（88．5％）术后效果满意,2例（2只眼）矫正不足,1只眼出现过矫。结论 腱膜性上睑下垂如诊断明确,手术方法适当,效果良好。     

腱膜性上睑下垂的手术治疗

目的 探讨腱膜性上睑下垂的手术治疗方法及效果。方法 对10例（11眼）腱膜性上睑下垂患者施行提上睑肌腱膜折叠术,随访3-18月。平均8.5月。结果 所有病例上睑下垂得到矫正,收到良好的美容效果。结论 提上睑肌腱膜折叠术是矫治腱膜性上睑下垂的有效方法之一。     

腱膜性上睑下垂的手术治疗

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。     

腱膜性上睑下垂的手术治疗

一、资料与方法 1.对象:本组病例共15例(18只眼),男9例,女7例,年龄最小18岁,最大76岁,平均42岁.老年性7例(10只眼),外伤性4例(4只眼),眼座植入术后1例(1只眼),双重睑术后1例(1只眼),长期佩戴隐形眼镜1例(1只眼),白内障术后1例(1只眼).提上睑肌肌力8～12 mm,平均9.5 mm.所有患者均伴有上睑皱襞抬高及上眶区凹陷.     

腱膜性上睑下垂手术的体会

目的探讨腱膜性上睑下垂的手术方法并总结手术的体会。方法对32例（50眼）腱膜性上睑下垂进行上睑提肌折叠术和上睑成形术,术后随访1—5年,平均3年。结果32例（50眼）中有30例（48眼）占98％眼术后效果较满意,2例欠矫,占4％。结论上睑提肌折叠和上睑成形术是矫治腱膜性上睑下垂的有效方法,但须重视根据术前检查和术中观察掌握手术量。     

前路腱膜修复术治疗腱膜性上睑下垂

目的 介绍腱膜性上睑下垂及其手术矫正的疗效。方法 18例（32只眼）腱膜性上睑下垂患者施行前路腱膜修复术治疗，术后随访至少3个月。结果 所有病例的上睑下垂均获矫正，并收到眼睑外形满意的美容效果。结论 简单的前路腱膜修复上睑下垂技术是一安全有效的矫正腱膜性上睑下垂的手术。     

提上睑肌缩短联合上横韧带加强术治疗复发性上睑下垂

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     

提上睑肌腱膜折叠术治疗老年性上睑下垂

0引言老年性上睑下垂是常见的眼睑疾病,不仅影响外观,也严重影响视功能。目前认为该病是由于提上睑肌腱膜结构改变——腱膜薄弱、断裂或形成裂孔所致[1]。我院2007-01/2011-06对36例60眼老年性上睑下垂患者行提上睑肌腱膜折叠术,取得了满意效果,现报道如下。     

Anatomy and surgery of the levator aponeurosis in senile ptosis

The authors performed an anatomical and histological study on eight eyelids to define the lower insertions of the levator muscle. Twenty-nine cases of senile ptosis are presented in which levator aponeurosis surgery was successful. All patients were operated under local anesthesia. The authors used an aponeurotic repair when an aponeurosis dehiscence was identified during surgery (12 cases). The preoperative clinical appearance of all of these patients was typical and suggested the presence of a defect in the aponeurosis. In the 17 other cases the authors used aponeurosis tucking. This technique is easy and rapid and can be performed on very old patients. Histological anomalies of the aponeurosis were found out from biopsies. There is an anatomical analogy between the upper and the lower lid, and equally between senile ptosis and senile entropion, characterized by laxity or disinsertion of the lower lid retractor. One patient with a disinsertion of the aponeurosis and of the lower lid retractor is presented.     

额肌腱膜悬吊术治疗重度上睑下垂8例

目的：探讨额肌腱膜悬吊术矫正重度上睑下垂的有效性。方法：8例(10眼)重度上睑下垂采用额肌腱膜悬吊术,利用额肌力量提起上睑。结果：术后上睑缘位于角膜上缘下1mm8眼,2mm2眼,无复发。结论：额肌腱膜悬吊术矫正重度上睑下垂效果确切。     

A contribution to the histological and topographical anatomy of the aponeurosis of the levator palpebrae superioris and of the tarsal muscle in the normal lid and in blepharoptosis

Eight normal upper lids were examinated histologically with special regard to the aponeurosis of the levator and of the tarsal muscle (Müller's). The aponeurosis originates from the levator muscle within the orbit (behind the septum orbitale) and inserts at the upper anterior surface of the tarsal plate. The tarsal muscle originates from the levator muscle and inserts at the upper tarsal border. It is a smooth muscle containing many small blood vessels. Fifty-six specimens of tissue resected in operations for blepharoptosis were examined histologically. They consist of parts of the tarsal muscle and of the aponeurosis of the levator and of fat tissue without pathological changes.     

额肌上睑提肌联合手术治疗重度上睑下垂

目的探讨重度上睑下垂的治疗方法。方法分析收治的48例重度上睑下垂患者行额肌上睑提肌联合手术治疗的疗效。结果 48例手术效果良好。2例因悬吊过高,于半年后恢复。双侧睑裂大小,重睑高度一致,睑缘弧度自然,流畅,眼睑闭合无角膜暴露,皱额耸眉姿态消失,随诊半年至1年效果满意。结论额肌上睑提肌联合手术治疗重度上睑下垂效果良好。     

提上睑肌缩短术治疗完全性先天性上睑下垂的临床观察

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。     

Accessory levator muscle slips of the levator palpebrae superioris muscle

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.     

改良提上睑肌缩短术矫正上睑下垂

目的:探讨改良提上睑肌缩短术矫正上睑下垂的效果。方法:保留提上睑肌腱膜与上睑的连接方式不变,采用提上睑肌腱膜复合瓣与缩短的提上睑肌腱膜吻合术矫正19例20眼上睑下垂。结果:术后4～10mo随访,治愈18例19眼,欠矫1例1眼,无过矫病例。结论:改良提上睑肌缩短术与常规手术比较有改进,术后的睑缘高度易保持在上方角膜缘,弧度与健侧对称自然,不易形成眼角畸形,能较好提高矫治效果。     

先天性上睑下垂的手术矫正

目的报告先天性上睑下垂手术矫正的效果,并对其疗效进行评价。方法对234例(308眼)先天性上睑下垂病人,均采用前路提上睑肌缩短术,重度上睑下垂采用提上睑肌超常量缩短术。结果术后平视睑裂高度6～9mm者280眼(90.9%),上睑缘弧度及双重睑形成良好,双侧眼窝深度对称。197眼重度上睑下垂行提上睑肌超常量缩短术后均有不同程度的睑裂闭合不全,术后1～3月恢复眼睑闭合功能,10眼结膜脱垂。结论该术式是治疗先天性上睑下垂比较理想且符合解剖生理的可行术式。目的报告先天性上睑下垂手术矫正的效果,并对其疗效进行评价。方法对234例(308眼)先天性上睑下垂病人,均采用前路提上睑肌缩短术,重度上睑下垂采用提上睑肌超常量缩短术。结果术后平视睑裂高度6～9mm者280眼(90.9%),上睑缘弧度及双重睑形成良好,双侧眼窝深度对称。197眼重度上睑下垂行提上睑肌超常量缩短术后均有不同程度的睑裂闭合不全,术后1～3月恢复眼睑闭合功能,10眼结膜脱垂。结论该术式是治疗先天性上睑下垂比较理想且符合解剖生理的可行术式。     

提上睑肌腱膜折叠术在上睑成形术中的应用

目的:探讨上睑成形术中联合应用提上睑肌腱膜折叠术矫正轻度上睑下垂的手术效果。方法:对326例652眼行上睑成形术,其中36例65眼合并轻度上睑下垂,在行上睑成形术同时行提上睑肌腱膜折叠术。结果:随访1～6mo,重睑对称流畅,上睑下垂矫正,睑裂平均提高1.5mm。轻度成角畸形2眼,通过局部按摩于术后3mo消失。术后欠矫1眼,术后早期闭睑不全1～3(平均2.1)mm,1mo后闭睑不全消失,无暴露性角膜炎发生。结论:轻度上睑下垂患者行上睑成形术时联合实施提上睑肌腱膜折叠术,可提高上睑成形术的成功率与患者满意度。     

改进的上睑提肌缩短术矫治上睑下垂的临床分析

目的评价上睑提肌缩短术矫治上睑下垂的效果。方法共治疗上睑下垂28例37眼，其中轻度10例16眼，中度18例21眼。此改进的术式与常规术式不同之处在于增加分离上睑提肌腱膜的长度(22mm)和宽度(16mm)，腱膜在睑板上固定4对缝线，以增加其牢固度。结果术后3～4月进行随访，成功35眼(94．59％)，上睑缘达角膜上缘以下1mm；2眼(5．41％)上睑缘达角膜上缘以下1．5～2mm。结论该上睑提肌缩短术与常规手术比较有改进，术后的睑缘高度易保持在上方角膜缘，弧度与健侧对称，不易形成眼角畸形，能较好提高矫治效果。