提上睑肌缩短术+睑板部分切除术治疗中重度上睑下垂患者的疗效及安全性分析

目的分析提上睑肌缩短术+睑板部分切除术治疗中重度上睑下垂患者的疗效及安全性.方法选取我院2017年6月~2019年5月收治的中重度上睑下垂患者86例,依据随机数字表法分为2组,即对照组(43例)、研究组(43例),其中对照组行提上睑肌缩短术治疗,研究组行提上睑肌缩短术、睑板部分切除术联合治疗,对比两组疗效、并发症发生状况、上睑缘高度对称情况以及术前、术后1个月、6个月眼睑状况[上睑缘到瞳孔中点距离(MRD)、睑裂高度、上睑回退量].结果研究组总有效率为83.72%(36/43),高于对照组62.79%(27/43,P<0.05);研究组上睑缘高度对称优良率为97.67%(42/43),高于对照组72.09%(31/43,P<0.05);两组术后1个月、6个月MRD大于术前,睑裂高度小于术前(P<0.05);术后1个月、6个月,研究组上睑回退量小于对照组(P<0.05);研究组并发症发生率对比,研究组11.63%(5/43)小于对照组30.23%(13/43,P<0.05).结论中重度上睑下垂患者采用提上睑肌缩短术联合睑板部分切除术治疗效果显著,可明显改善上睑缘高度对称度以及眼睑状况,减少并发症发生,安全性高.

Efficacy and safety analysis of upper levator muscle shortening plus partial meibomectomy for patients with moderate to severe ptosis

Objective To analyze the efficacy and safety of upper levator muscle shortening plus partial meibomectomy for patients with moderate to severe ptosis.Methods A total of 86 patients with moderate to severe ptosis were treated in our hospital from June 2017 to May 2019,and they were divided into two groups according to the random number table method,namely the control group(43 cases)and the research group(43 cases),the control group received upper levator muscle shortening,and the study group received upper levator shortening and partial meibomectomy,the efficacy,complications,height symmetry of the upper eyelid margin,and eyelid conditions[distance from the upper eyelid margin to the midpoint of the pupil(MRD),the height of the eyelid fissure,and the amount of upper eyelid retraction]before surgery,one month,and six months after surgery were compared between the two groups.Results The total effective rate of the study group was 83.72%(36/43),which was higher than the control group at 62.79%(27/43,P<0.05);the excellent symmetry rate of upper eyelid margin in the study group was 97.67%(42/43),which was higher than the control group at 72.09%(31/43,P<0.05);after one month and six months,the MRD of the two groups was greater than that before surgery,and the height of the eyelid fissure was less than before surgery(P<0.05);at one and six months after surgery,the amount of upper eyelid retreat in the study group was less than that in the control group(P<0.05);compared with the incidence of complications in the study group at 11.63%(5/43)in the study group was less than that in the control group at 30.23%(13/43,P<0.05).Conclusion Patients with moderate to severe blepharoptosis are treated with superior levator muscle shortening combined with partial meibomectomy,which can significantly improve the high symmetry of the upper eyelid margin and the condition of the eyelids,reduce the occurrence of complications and have high safety.