重度先天性上睑下垂不同术式的比较

目的 分析异体阔筋膜悬吊术,超常量提上睑肌缩短术和改良的额肌瓣腱膜悬吊术治疗矫正重度先天性上睑下垂的效果.方法 对189例(189只眼)重度先天性上睑下垂住院病例进行手术治疗,其中改良的额肌瓣腱膜悬吊术80例,异体阔筋膜悬吊术39例,超常量提上睑肌缩短术70例.结果 三种手术方法均获得很好的治疗效果异体阔筋膜悬吊术,双重睑形成好,但复发率高,取材困难;超常量提上睑肌缩短术,手术合乎生理要求,但术后易发生睑裂闭合不全及结膜脱垂;改良的额肌瓣腱膜悬吊术,取材方便,复发率低,但双重睑形成差.结论 异体阔筋膜悬吊术,超常量提上睑肌缩短术和改良的额肌瓣腱膜悬吊术均能有效治疗重度先天性上睑下垂,临床上可根据患者的条件及意愿综合评估,灵活选择相应术式.

Abstract：

Objective To analyze the effect of three operations for severe congenital blepharoptosis.Methods All 189 cases of severe congenital blepharoptosis, among which 80 cases(80 eyes)with improved suspension of frontal muscle flap, 39 cases(39 eyes)with frontal muscle suspension with allogeneic femoral fascia, other 70 cases(70 eyes)with supernormal shortening palpabralis. Results The frontal muscle suspension with allogeneic femoral fascia formed good double eyelid but with a high recurrence rate and the material was hard to get. Supernormal shortening palpabralis met the physiological requirement but easily leaded to lagophthalmos and conjunctiva procidentia. The improved suspension of frontal muscle flap hardly formed double eyelid but with a low recurrence rate, and the material was easy to get. Conclusions The three operations are all effective for Severe Congenital Blepharoptosis. The oculist should adopt the right operation according to the patients case and willing.

Comparison of different operations for Severe Congenital Blepharoptosis

Objective To analyze the effect of three operations for severe congenital blepharoptosis.Methods All 189 cases of severe congenital blepharoptosis, among which 80 cases(80 eyes)with improved suspension of frontal muscle flap, 39 cases(39 eyes)with frontal muscle suspension with allogeneic femoral fascia, other 70 cases(70 eyes)with supernormal shortening palpabralis. Results The frontal muscle suspension with allogeneic femoral fascia formed good double eyelid but with a high recurrence rate and the material was hard to get. Supernormal shortening palpabralis met the physiological requirement but easily leaded to lagophthalmos and conjunctiva procidentia. The improved suspension of frontal muscle flap hardly formed double eyelid but with a low recurrence rate, and the material was easy to get. Conclusions The three operations are all effective for Severe Congenital Blepharoptosis. The oculist should adopt the right operation according to the patients case and willing.