Frontalis Sling Operation Using Silicone Rod Compared with Preserved Fascia Lata for Congenital Ptosis A Three-Year Follow-up Study
Frontalis Sling Operation Using Silicone Rod Compared with Preserved Fascia Lata for Congenital Ptosis A Three-Year Follow-up Study
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DOI：
10.1016/j.ophtha.2008.08.049
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发表时间：
2009-01-01
期刊：
影响因子：
13.7
通讯作者：
Khwarg, Sang In
中科院分区：
文献类型：
--
作者：
Lee, Min Joung;Oh, Joo Youn;Khwarg, Sang In
目的：比较硅胶棒与保留阔筋膜额肌悬吊术治疗先天性上睑下垂的3年疗效。设计：回顾性、非随机、比较性、干预性病例系列。研究对象：先天性上睑下垂患者123例。方法：回顾性分析123例先天性上睑下垂行额肌悬吊手术的临床资料。根据使用的吊带材料将患者分为两组；保留阔筋膜组（n = 63）和硅胶棒组（n = 60）。比较两组患者的美容效果及复发率。根据习惯上睑高度及对称性评价额肌悬吊手术的美容效果为好、一般、差，并将双侧病例与单侧病例分别进行比较。复发被定义为美容结果从良好或一般到较差类别的转换。主要观察指标：术后美容效果及复发率。结果：随访3、6个月时，两组患者的美容效果差异无统计学意义（经比例趋势检验，双侧P = 0.17、P = 0.25，单侧P = 0.14、P = 0.35）。然而，在双侧和单侧病例中，硅胶棒组在术后1、2、3年的美容效果均明显优于保留筋膜组（经Armitage’s比例趋势检验，P < 0.05）。术后3年，硅胶棒组复发率分别为29.2%（7/24双侧）和11.1%（3/27单侧），保留阔筋膜组复发率分别为63.2%（12/19双侧）和41.4%（12/29单侧）。结论：考虑到本回顾性研究的局限性，与保留阔筋膜手术相比，使用硅胶棒的额肌悬吊手术在先天性上睑下垂术后3年内具有更好的美容效果和更低的复发率。然而，只有前瞻性随机研究才能在这方面给出更准确的结论。财务披露：作者在本文中讨论的任何材料中没有专有或商业利益。眼科2009;116:123-129 (C) 2009年美国眼科学会。
Purpose: To evaluate the 3-year results of frontalis sling operation using a silicone rod compared with preserved fascia lata for congenital ptosis.Design: Retrospective, nonrandomized, comparative, interventional case series.Participants: One hundred twenty-three patients with congenital ptosis.Methods: The medical records of 123 patients who underwent a frontalis sling operation for congenital ptosis were retrospectively reviewed. Patients were divided into 2 groups according to the sling material used; a preserved fascia lata group (n = 63) and a silicone rod group (n = 60). Cosmetic results and recurrence rates were compared between these 2 groups. The cosmetic results of the frontalis sling operation were assessed as good, fair, or poor based on the habitual upper lid heights and symmetry, and bilateral cases and unilateral cases were compared separately. Recurrence was defined as the conversion of the cosmetic result from good or fair to poor category.Main Outcome Measures: Postoperative cosmetic results and recurrence rate.Results: At the 3- and 6-month follow-ups, the cosmetic results were not significantly different between the 2 groups (P = 0.17 and P = 0.25 for bilateral cases and P = 0.14 and P = 0.35 for unilateral cases, respectively, by Armitage's test of trend in proportions). However, the silicone rod group showed significantly better cosmetic results than the preserved fascia lata group at 1, 2, and 3 years after surgery in both bilateral and unilateral cases (all P < 0.05, by Armitage's test of trend in proportions). At 3 years after surgery, the recurrence rates were 29.2% (7/24 bilateral cases) and 11.1% (3/27 unilateral cases) for the silicone rod group, and 63.2% (12/19 bilateral cases) and 41.4% (12/29 unilateral cases) for the preserved fascia lata group.Conclusions: Given the limitations of this retrospective study, the frontalis sling operation using a silicone rod showed better cosmetic results and lower recurrence rate compared to the procedure using preserved fascia lata up to 3 years after surgery for congenital ptosis. However, only prospective randomized studies can give a more accurate conclusion in that regard.Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Ophthalmology 2009; 116:123-129 (C) 2009 by the American Academy of Ophthalmology.