先天性上睑下垂手术后并发症原因分析与处理

目的:探讨先天性上睑下垂术后并发症原因及治疗方法。方法:对在我院住院行先天性上睑下垂再次手术的患儿20例21眼进行观察分析并行手术治疗,追踪手术疗效。结果:再次手术原因:上睑内翻倒睫8例9眼,上睑下垂矫正不足14例14眼,上睑下垂矫正不足伴眼睑部分缺损瘘管形成1例1眼,双重睑外形不美观18例19眼。14眼行额肌瓣缝线调整术,1眼行额肌瓣悬吊术+瘘道切除眼睑缺损修复术,4眼行额肌瓣悬吊术,2眼行额肌瓣加固术。所有患儿术后追踪观察0.5～1a,效果满意。除轻度的上睑迟滞现象以外无其余并发症。结论:上睑下垂术后并发症多种多样,治疗无固定的模式,需根据具体情况进行个性化处理。术前全面检查、正确选择手术方式、提高手术技巧是减少手术并发症的关键。

Discussion on the causes and treatment of postoperative complications in congenital ptosis

AIM:To investigate the causes and treatment methods of postoperative complications in congenital ptosis. METHODS: A total of 20 children(21 eyes) who requested reoperation after the correction of congenital ptosis from 2005 to 2010 were surveyed and treated,to observe the effect of surgical treatment.RESULTS: The causes of reoperation were entropion trichiasis (9 eyes),under-corrected ptosis(14 eyes),under-corrected ptosis and eyelid defect companion fistula formation (1 eye),unsatisfied shape of double eyelids (19 eyes).14 eyes were operated with frontal muscle flap’s suture adjustable. 1 eye was operated with frontal muscle flap suspention and fistula resection combined reconstruction of eyelid defect. 4 eyes were operated with frontal muscle flap suspention. 2 eyes were performed with frontal muscle flap reinforcement. Through the observation after operation for 0.5-1 year,the postoperative effects of all patients were satisfactory except lid lag more or less. CONCLUSION: The postoperative complications of ptosis are varied. There are never fixed pattern to treat complications. We should modify our surgical methods in accordance with specific conditions. The adequate preoperative examination and the choice of correct operation technique,improving surgical skills are the key points to reduce the postoperative complications. 