中重度Marcus-Gunn综合征患者的临床特点及其手术治疗

目的分析中重度Marcus-Gunn综合征患者的临床特点,探讨和评价其手术治疗效果。方法对中山大学中山眼科中心1997年7月至2003年7月收治的33例中重度Marcus-Gunn综合征患者的病历资料进行临床特点分析。患者均行单侧提上睑肌节段切除联合同侧额肌肌瓣悬吊术治疗上睑下垂,评价其术后治疗效果。结果所有患者术前的上睑下垂及颌动瞬目量均大于2mm,无家族史,无明显性别差异（男：女=16：17）,左眼（22例）多于右眼（11例）。术后随访1—6年。随访期末进行的上睑下垂矫治效果评价中26／33例患者满意,3／33例较满意,1／33例不满意,另有3例失访。结论中重度Marcus-Gunn综合征患者伴有的上睑下垂需行手术矫正。单侧提上睑肌节段切除联合同侧额肌肌瓣悬吊术可以满意地矫正中重度Marcus-Gunn综合征患者的上睑下垂。

Clinical characteristics of moderate and severe Marcus-Gunn jaw-winking synkinesis and its surgical treatment

OBJECTIVE: To investigate the clinical characteristics of moderate and severe Marcus-Gunn jaw winking synkinesis and it surgical management. METHODS: Thirty-three patients with Marcus-Gunn syndrome were enrolled from 1997 to 2003 in Zhongshan Ophthalmic Center. The clinical characteristics were analyzed based on the records. Unilateral levator excision and frontalis flap suspension were performed for the correction of ptosis and the results were analyzed. RESULTS: The follow-up period varied from 1 to 6 years. Sixteen patients were male and 17 were female. The left eye was involved in 22 patients and the right eye in 11 patients. There was no family history. The amount of ptosis in each patient was more than 2 mm. At the end of observation, good results were achieved for ptosis correction in 26 (87%) of 30 patients, fair results in 3 (10%) patients. CONCLUSIONS: The ptosis of patients with moderate and severe Marcus-Gunn syndrome needs to be treated surgically. Unilateral frontalis flap suspension combined levator excision can correct ptosis very well for patients with moderate and severe Marcus-Gunn syndrome.