PDF(Pubmed)
Abstract：
BACKGROUND: To compare outcomes of lower eyelid retraction repair using a subperiosteal midface lifting technique with and without posterior lamellar grafts.
METHODS: Charts of patients undergoing a sub-periosteal midface lift for treatment of lower eyelid retraction using 4 techniques for posterior lamellar reconstruction were reviewed. Thirty patients were included in each of the groups: midface with hard palate graft (HPG), midface lift with acellular cadaveric graft (ADG), midface lift with retractor disinsertion (RD) and midface lift alone (NG). Measurements of distance from pupil center to lower lid margin (MRD2) and from lateral limbus to lower lid margin (MRD2limbus) were taken from pre- and postoperative photographs and compared. Secondary outcomes included rates of reoperation, major and minor complications, resolution of symptoms and keratopathy.
RESULTS: One hundred twenty operations were assessed (n = 30 for each surgical group). The average follow-up time was 20 weeks. The median MRD2 elevation was 0.95 mm (NG), 0.85 mm (HPG), 1.59 mm (ADG) and 1.02 mm (RD). The median MRD2limbus elevation was 1.06 mm (NG), 0.92 mm (HPG), 1.45 mm (ADG) and 1.12 mm (RD). There were no significant differences in MRD2 or MRD2limbus between the 4 groups (p = 0.06 and 0.29, respectively). Reoperation rates were highest with in the hard palate graft group (33%) compared to other techniques (p = 0.0006).
CONCLUSIONS: Similar degrees of lower eyelid elevation were achieved with all the midface lifting techniques, and complication rates did not significantly differ between techniques. However, the higher reoperation rates with the use of spacer grafts suggest that a no-graft technique may be preferable.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: Charts of patients undergoing a sub-periosteal midface lift for treatment of lower eyelid retraction using 4 techniques for posterior lamellar reconstruction were reviewed. Thirty patients were included in each of the groups: midface with hard palate graft (HPG), midface lift with acellular cadaveric graft (ADG), midface lift with retractor disinsertion (RD) and midface lift alone (NG). Measurements of distance from pupil center to lower lid margin (MRD2) and from lateral limbus to lower lid margin (MRD2limbus) were taken from pre- and postoperative photographs and compared. Secondary outcomes included rates of reoperation, major and minor complications, resolution of symptoms and keratopathy.
RESULTS: One hundred twenty operations were assessed (n = 30 for each surgical group). The average follow-up time was 20 weeks. The median MRD2 elevation was 0.95 mm (NG), 0.85 mm (HPG), 1.59 mm (ADG) and 1.02 mm (RD). The median MRD2limbus elevation was 1.06 mm (NG), 0.92 mm (HPG), 1.45 mm (ADG) and 1.12 mm (RD). There were no significant differences in MRD2 or MRD2limbus between the 4 groups (p = 0.06 and 0.29, respectively). Reoperation rates were highest with in the hard palate graft group (33%) compared to other techniques (p = 0.0006).
CONCLUSIONS: Similar degrees of lower eyelid elevation were achieved with all the midface lifting techniques, and complication rates did not significantly differ between techniques. However, the higher reoperation rates with the use of spacer grafts suggest that a no-graft technique may be preferable.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：比较使用骨膜下面部中段抬升技术进行下眼睑回缩修复的结果，包括后板层移植。
方法：回顾了使用4种后路板层重建技术进行骨膜下面部中部提升治疗下睑退缩的患者的图表。每组包括30例患者：中面硬腭移植物（HPG），用无细胞尸体移植物（ADG）进行面部提升，带牵引器插入的中面提升（RD）和单独的中面提升（NG）。从术前和术后照片中测量从瞳孔中心到下睑缘（MRD2）以及从侧缘到下睑缘（MRD2limbus）的距离并进行比较。次要结果包括再手术率，主要和次要并发症，症状和角膜病变的解决。
结果：评估了120次手术（每个手术组n=30）。平均随访时间为20周。MRD2高程中位数为0.95mm(NG),0.85毫米(HPG),1.59毫米（ADG）和1.02毫米（RD）。MRD2角膜缘高程中位数为1.06mm(NG),0.92毫米（HPG），1.45毫米（ADG）和1.12毫米（RD）。4组之间的MRD2或MRD2角膜缘没有显着差异（分别为p=0.06和0.29）。与其他技术相比，硬腭移植组的再手术率最高（33％）（p=0.0006）。
结论：所有中脸提升技术都能达到相似的下眼睑抬高程度，不同技术的并发症发生率无显著差异.然而,使用间隔移植物的较高的再手术率表明，无移植技术可能是优选的。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：回顾了使用4种后路板层重建技术进行骨膜下面部中部提升治疗下睑退缩的患者的图表。每组包括30例患者：中面硬腭移植物（HPG），用无细胞尸体移植物（ADG）进行面部提升，带牵引器插入的中面提升（RD）和单独的中面提升（NG）。从术前和术后照片中测量从瞳孔中心到下睑缘（MRD2）以及从侧缘到下睑缘（MRD2limbus）的距离并进行比较。次要结果包括再手术率，主要和次要并发症，症状和角膜病变的解决。
结果：评估了120次手术（每个手术组n=30）。平均随访时间为20周。MRD2高程中位数为0.95mm(NG),0.85毫米(HPG),1.59毫米（ADG）和1.02毫米（RD）。MRD2角膜缘高程中位数为1.06mm(NG),0.92毫米（HPG），1.45毫米（ADG）和1.12毫米（RD）。4组之间的MRD2或MRD2角膜缘没有显着差异（分别为p=0.06和0.29）。与其他技术相比，硬腭移植组的再手术率最高（33％）（p=0.0006）。
结论：所有中脸提升技术都能达到相似的下眼睑抬高程度，不同技术的并发症发生率无显著差异.然而,使用间隔移植物的较高的再手术率表明，无移植技术可能是优选的。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
