改良额肌瓣悬吊术矫正重度上睑下垂的临床疗效观察

摘要

Objective To explore clinical observation of the effect of severe blepharoptosis correction with modified frontalis muscle suspension.Methods Thirty three cases (41 eyes) with congenital severe blepharoptosis were treated with modified frontalis muscle suspension,and the operative effect was analyzed retrospectively.Double eyelid incision and concealauxiliary incision on partial-bitamporal of the superciliary arch were adopted.After taking the frontal muscle flap crossed through the subcutaneous tunnel between two incisions and fixed on the superior tarsus.Closed palpebral fissure with suture method after adjustment was satisfied.Results At 1 ～ 24 (9.76 ± 5.15) months post-operatively,all incisions of 33 cases were primary healing,eyelid radian satisfaction and no corneal exposure complication occurrence.The early postoperative reaction was mild,while only 1 case discovered subcu-taneoushematoma in superciliary arch.The satisfactory corrections were 30 cases,which undercorrections were 2 cases and 1 case was over correction.No palpebral and exposed keratotitislong-tern complication was found.Conclusions The operation of modified frontalis muscle suspension is satisfactory,safe and effective with little complications and less injury in intraoperative.%目的 探讨改良的额肌瓣悬吊术矫正先天性重度上睑下垂的临床疗效.方法 回顾性分析采用改良的额肌瓣悬吊术对33例(41眼)先天性重度上睑下垂患者手术治疗的临床资料,采用重睑切口及眉弓隐蔽处偏外侧辅助切口,取额肌瓣后从两切口之间的皮下隧道穿过并固定于睑板上缘,调整幅度满意后再用缝线法闭合睑裂.术后观察睑裂高度及早晚期并发症的发生率.结果 术后所有患者完成1 ～24(9.76 ±5.15)个月的随访复查:切口均一期愈合,睑缘弧度满意,无角膜暴露.术后早期反应轻,仅1例患者术后出现眉弓部皮下血肿,欠矫2例(2眼),过矫1例(1眼),其余患者上睑下垂均得到明显改善.无一例出现角膜及眼睑的长期并发症.结论 改良额肌瓣悬吊术治疗先天性重度上睑下垂疗效满意可靠,术中损伤小,并发症少.