背景:对于与公平提肌功能(LF)相关的中度上睑下垂,提上肌切除术是最常用的手术。然而,提上肌切除术技术仍然有一些缺点,如残留眼角(RL),校正不足,结膜脱垂,和眼睑轮廓异常。为了解决上述问题,我们的团队在三个方面对提上肌切除术技术进行了修改:充分释放提上肌,保留结膜的支撑结构,并放置多个缝合部位。
方法:57例患者(81只眼)接受了改良的提上肌切除术技术,并被纳入研究。术前收集的数据包括年龄,性别,边缘反射距离1(MRD1),和LF。术后收集的数据包括MRD1、RL、患者满意度,并发症,和后续时间。
结果:平均MRD1从术前的1.45±0.65mm显著增加至术后的3.57±0.51mm。平均LF从术前的6.49±1.12mm显著增加至术后的9.48±1.39mm。77只眼(95.1%)成功矫正。平均RL为1.09±0.57,72眼(88.9%)表现出良好或良好的眼睑闭合功能。54例(94.7%)患者对最终结果完全满意。并发症如血肿,感染,结膜脱垂,缝线暴露,角膜擦伤,随访期间未发现角膜炎。
结论:这项研究中引入的改良提上睑切除术技术可有效纠正中度先天性上睑下垂,在最小化RL的同时,校正不足,结膜脱垂,通过充分释放提上肌,眼睑轮廓异常,保留结膜的支撑结构,并放置多个缝合部位。
方法:本期刊要求作者42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43个描述,44请参阅目录或在线45对作者的说明www。springer.com/00266.
For moderate ptosis associated with fair levator function (LF), the levator resection is the most commonly used procedure. However, the levator resection technique still has some disadvantages, such as residual
lagophthalmos (RL), undercorrection, conjunctival prolapse, and eyelid contour abnormality. To solve the above problems, our team have made modifications to the levator resection technique in three aspects: releasing the levator muscle sufficiently, preserving the supporting structure of the conjunctiva, and placing multiple suture sites.
Fifty-seven patients (81 eyes) underwent the modified levator resection technique and were enrolled in the study. Preoperative data collected included age, sex, margin reflex distance 1 (MRD1), and LF. Postoperative data collected included MRD1, RL, patient satisfaction, complications, and length of follow-up.
Mean MRD1 significantly increased from 1.45 ± 0.65 mm preoperatively to 3.57 ± 0.51 mm postoperatively. Mean LF significantly increased from 6.49 ± 1.12 mm preoperatively to 9.48 ± 1.39 mm postoperatively. Successful correction was obtained in 77 eyes (95.1%). Mean RL was 1.09 ± 0.57 and 72 eyes (88.9%) showed excellent or good eyelid closure function. Fifty-four patients (94.7%) were completely satisfied with the final result. Complications such as hematoma, infection, conjunctival prolapse, suture exposure, corneal abrasion, and keratitis were not found in any cases during follow-up.
This modified levator resection technique introduced in this study is effective in correcting moderate congenital blepharoptosis, while minimizing RL, undercorrection, conjunctival prolapse, eyelid contour abnormality by releasing the levator muscle sufficiently, preserving the supporting structure of the conjunctiva, and placing multiple suture sites.
This journal requires that authors 42 assign a level of evidence to each article. For a full 43 description of these Evidence-Based Medicine ratings, 44 please refer to the Table of Contents or the online 45 Instructions to Authors www.springer.com/00266 .