上睑下垂的术前评估及改良提上睑肌缩短术矫治的疗效评价

目的评价改良提上睑肌缩短术矫治上睑下垂的效果。方法采用改良提上睑肌缩短术[此改良术式与常规术式不同之处在于增加分离提上睑肌腱膜的长度(22mm)和宽度(16mm),腱膜在睑板上固4对缝线,以增加其牢固度],共治疗上睑下垂57例68眼,其中轻度13例13眼,中度38例47眼,重度6例8眼。结果术后4～36个月随访,治愈48例59眼,欠矫9例9眼,无过矫病例。结论该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,不易形成眼角畸形,能较好提高矫治效果。

Evaluation of blepharoptosis before operation and effect of the modified resection of levator palpebrae superioris

Objective To evaluate the effect of the resection of levator aponeurosis for the treatment of blepharoptosis. Methods Shortening of levator aponeurosis was performed on the consecutive 57 cases (68 eyes), among which 13 cases (13 eyes) were mild, 38 cases (47 eyes) moderate, and 6 cases (8 eyes) severe ptosis. The difference between this procedure and the traditional one was that the tendon of the lavatory palpebrae muscle was separated up to 22 mm in length and 16 mm in width, and tendon was fixed to enhance the stability. Results After 4-36 months follow-up (mean 13 months), 48 cases (59 eyes) were corrected successfully, but 9 cases (9 eyes) were corrected insufficiently, and none of them were corrected excessively. Conclusion The shortening of levator aponeurosis makes it better than the traditional one that altitude of the upper eyelid keeps above the limbus corneae and the curve symmetrizes the healthy one, in which canthus deformity dose not occur easily.