上睑提肌联合Müller's肌缩短矫正轻中度先天性上睑下垂

摘要

Objective To investigate the therapeutic effect of levator muscle combined with Müller's muscle shortening for treatment of mild and moderate congenital blepharoptosis.Methods Thirty-one cases (38 eyes) with mild or moderate congenital blepharoptosis were treated through both skin and conjunctiva approach.The levator muscle was exposed through skin approach.The Müller's muscle was separated from conjunctiva through conjunctiva approach.The combined flap of levator muscle and Müller's muscle was freed from the upper edge of tarsus and shortened.Then the combined flap was fixed on the upper 2/3 portion of tarsus to correct the ptosis.Results All the patients were followed up for 6-24 months with satisfactory result.The result was graded as good 12 eyes,generally 21 eyes,inadequate correction 3 eyes,over-correction 1 eye,and nvalid correction 1 eye.The effective rate was 86.8％.Conclusions The levator muscle combined with Müller's muscle shortening is a very simple and practicle method for mild to moderate congenital blepharoptosis with satisfactory result.%目的 探讨上睑提肌联合Müller's肌缩短治疗轻、中度先天性上睑下垂的方法及临床效果.方法 对31例(38只眼)轻、中度先天性上睑下垂患者采用皮肤及睑结膜两侧人路,于皮肤面分离显露上睑提肌表面,于结膜面经上穹窿内、外侧小切口分离结膜与Müller's肌,睑板上缘处离断肌肉形成上睑提肌与Müller's肌复合组织瓣,将其相应缩短并调整后固定于睑板中上1/3处,对上睑下垂进行矫正.结果 对本组病例进行术后短期和6～24个月随访观察,矫正效果良好12只眼;矫正效果一般21只眼;矫正不足3只眼;过度矫正1只眼.无效矫正1只眼,有效矫正率86.8％,治疗效果满意.结论 上睑提肌联合Müller's肌缩短治疗轻、中度先天性上睑下垂方法简单易行,效果满意.